Phytotherapy and treatment of cystitis: current trends


  • D.D. Ivanov MD, PhD, Professor, Head of the Department of nephrology and renal replacement therapy, Shupyk National Medical Academy of Postgraduate Education, Kyiv



cystitis, antibiotic resistance, nifuratel, Сanephron H, combination of methylthioninium chloride and herbal extracts, cranberry extract, combination of purified lysates


The treatment of lower urinary tract infections, in particular cystitis, remains an urgent problem of modern medicine. The high prevalence of the disease, formation of resistant strains of cau­sative microorganisms, a change in microbiota, and a limited arsenal of antimicrobial agents lead to an annual change in recommendations for the rational treatment of cystitis. The latest recommendations of the European Association of Urology (2019) significantly limit the use of antibiotics, in particular fluoroquinolones, among which, in our opinion, 3rd generation cephalosporins in a three-day regimen remains a priority in the absence of intracellular pathogens. National experience indicates the widespread successful use of urinary antiseptics among modern nitrofurantoins, resistance to which is documented in a very limited number of people with cystitis. Given that cystitis occurs mainly in women, we consider it advisable to recommend nifuratel as a first-line drug for 5–7 days. It has a wide spectrum of action and is effective for both specific and non-specific vulvovaginitis and bacterial vaginosis, which is often a provoking factor for cystitis. Among the alternative over-the-counter drugs that successfully form the evidence base, one should note a phytoniring drug. To maintain the function and reduce the risk of exacerbation of inflammatory genitourinary system diseases — dietary supplements, those containing 36 mg A-type proanthocyanidin and methylthioninium chloride, prescribed for 10 days. These compounds, along with nifuratel, are also successfully used in the form of a prophylactic reduced dose once per night for one to six months.





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