Kuzmenko A V, Kuzmenko V V, Gyaurgiev T A
Voronezh State Medical University n.a. N.N. Burdenko, Voronezh, Russia.
Urologiia. 2019 Dec 31(6):38-43.
Acute cystitis is the most common manifestation of uncomplicated urinary tract infection. One of the drugs whose effectiveness in the treatment of patients with INMP has been proven is fosfomycin, which has been on the pharmaceutical market for a long time and is widely used in urological practice. despite the good results of etiotropic therapy, the problem of recurrent UTI remains unresolved, which occurs in about 30% of women within a year after the first episode of cystitis. alternative prophylactic agents, such as probiotics, cranberry preparations, phytopreparations, etc. are increasingly used in prolongation of the inter-relapse period. One such remedy is D-mannose.
to evaluate the effectiveness of D-mannose and the combined drug Ecofomural containing fosfomycin and lactulose in the complex treatment of women with uncomplicated lower urinary tract infection.
60 women with acute uncomplicated cystitis were examined and treated. By random sampling, all women were divided into 2 groups of 30 people. In group 1, antibiotic therapy with Ecofomural once 1 sachet after urination was prescribed. The product contains 3G of fosfomycin and 1.5 g of prebiotic lactulose. In group 2, a similar antibacterial therapy with the enrichment of the diet with a source of D-mannose (Ecocystin) 1 sachet 1 time per day for 6 months. Evaluation of the effectiveness of antibacterial therapy was carried out on the 3rd and 7th day. It included analysis of dysuric symptoms according to diaries of urination, assessment of pain intensity, laboratory tests. Long-term results of therapy were evaluated within 6 months after taking the antibacterial drug. The examination included a comparative analysis of the frequency of relapses of the disease, filling diaries of urination and laboratory tests.
When treated, all women showed signs of acute cystitis. On the 3rd day of therapy in both groups there was a statistically significant (p<0.05) positive dynamics of the studied parameters. By the 7th day in both groups marked relief of dysuric phenomena and pain. The number of white blood cells in the urine of all patients was within normal values. During a further 6-month follow-up, relapses of the disease were detected in 7 (23.3%) patients in group 1 and in 1 (3.3%) in group 2. Bacteriological examination in group 1 revealed the same pathogen in 5 (16.7%) cases as in the first treatment. The other women had different pathogens.
The results of the study demonstrated the high efficacy and safety of complex therapy with Ecofomural containing fosfomycin and lactulose, in combination with long-term enrichment of the diet with D-mannose (Ecocystin) b in order to prolong the inter-relapse period of uncomplicated lower urinary tract infection.
急性膀胱炎是单纯性尿路感染最常见的表现形式。磷霉素是一种在治疗非复杂性下尿路感染（INMP）患者中已被证实有效的药物之一，它已在医药市场上存在很长时间且广泛应用于泌尿外科实践。尽管病因特异性治疗取得了良好效果，但复发性尿路感染问题仍未解决，约30%的女性在首次膀胱炎发作后的一年内会出现复发性尿路感染。越来越多的替代预防药物，如益生菌、蔓越莓制剂、植物制剂等，被用于延长复发间期。D-甘露糖就是其中一种药物。
评估D-甘露糖以及含磷霉素和乳果糖的复方药物Ecofomural在单纯性下尿路感染女性综合治疗中的有效性。
对60例急性单纯性膀胱炎女性进行检查和治疗。通过随机抽样，将所有女性分为两组，每组30人。第1组患者在排尿后服用1袋Ecofomural进行抗生素治疗。该产品含有3克磷霉素和1.5克益生元乳果糖。第2组患者进行类似的抗菌治疗，并在饮食中添加D-甘露糖来源（Ecocystin），每天1袋，持续6个月。在第3天和第7天对抗菌治疗的有效性进行评估。评估内容包括根据排尿日记分析排尿困难症状、疼痛强度评估以及实验室检查。在服用抗菌药物后的6个月内评估治疗的长期效果。检查包括对疾病复发频率、填写排尿日记和实验室检查的对比分析。
治疗时，所有女性均表现出急性膀胱炎症状。治疗第3天，两组研究参数均有统计学意义（p<0.05）的积极变化。到第7天，两组排尿困难现象和疼痛均明显缓解。所有患者尿液中的白细胞数量均在正常范围内。在接下来的6个月随访中，第1组有7例（23.3%）患者出现疾病复发，第2组有1例（3.3%）患者复发。第1组的细菌学检查显示，5例（16.7%）患者的病原体与首次治疗时相同。其他女性的病原体不同。
研究结果表明，含磷霉素和乳果糖的Ecofomural联合D-甘露糖（Ecocystin）长期丰富饮食进行综合治疗，对于延长单纯性下尿路感染的复发间期具有高效性和安全性。
