Assessment of chronometric indicators of the speed of the onset therapeutic effect and prevention of recurrences by using complex phytotherapy in patients with acute uncomplicated cystitis

Abstract

Urinary tract infections (UTIs) are a significant public health problem. Every year the situation becomes more complicated due to the high rate of recurrence and the growth of resistance among the population.Research results show that about 150 million people suffer from bacterial infections of the urinary tract every year, and about 6 million visits to the doctor about UTIs are registered in the US every year, of which more than 2 million are related to cystitis. In Ukraine, UTIs rank first among all urological diseases, more than 170,000 cystitis patients are registered annually for the first time. 20% of girls till 20 years old have at least one episode of acute cystitis, and 25–40% of women experience a recurrent episode within a year after an episode of acute cystitis.Treatment of cystitis depends on the influence of many factors, which include: age, gender, state of the immune system, recurrences, urological pathologies, severity of the disease and the risk of developing multiple drug resistance. For the prevention of the antibiotic resistance development, it is recommended to use combined herbal preparations for long-term prevention of episodes of recurrent cystitis.The objective: to evaluate the effectiveness of the use of the proposed herbal preparation in the complex treatment and prevention of recurrence in patients with acute uncomplicated cystitis and the chronometry of the onset of action of the drug in monotherapy.Materials and methods. The study was included the patients with acute uncomplicated cystitis. The main group involved 40 persons who were prescribed antibacterial therapy in the form of a single use of fosfomycin trometamol 3 g per os or sulfamethoxazole/trimethoprim 400 mg/80 mg 2 tablets twice a day for 5 days in combination with a herbal preparation (a combination of medicinal plant components of centaury herb, lovage root and rosemary leaves) 1 tablet 3 times a day for 3 months. Patients of the comparison group (40 subjects) received only antibacterial therapy.Treatment effectiveness and side effects were evaluated 10 days after its initiation. Determination of the presence and frequency of recurrence of the disease was carried out 3 and 6 months after its onset. At the second stage of the study, the effectiveness of the use of the herbal preparation was evaluated as a prevention of recurrence of cystitis and relief of its first signs.At the appearance of the first signs of recurrence of the disease within 6 months after the end of the primary course, patients of both groups were recommended to immediately start using the herbal preparation, 1 tablet three times a day. To determine the speed of the onset of the pharmaceutical action of the drug, each patient was asked to fill out a questionnaire regarding the chronometry of the reduction or disappearance of symptoms.Results. After completion of treatment, a positive effect was observed in 38 (95.0%) patients of the main group and 37 (92.5%) of the comparison group, leukocyturia stopped in 39 (97.5%) and 38 (95.0%) patients, respectively, dysuria – in 37 (92.5%) and 38 (95.0%), respectively. The effect of the proposed herbal preparation was maximally manifested in reducing the rate of recurrence of cystitis, which has important clinical significance.It is quite clear that for the occurrence of a sporadic episode of acute cystitis, timely and effective antibiotic therapy is self-sufficient and accordingly hides the effect of phytotherapy. Use of the proposed herbal preparation for 3 months provides long-term rehabilitation of the lower urinary tract due to the aquaretic and antimicrobial effect of the herbal preparation and prevents the recurrence of the disease.Conclusions. The use of the proposed herbal preparation as part of combined therapy in patients with acute uncomplicated cystitis demonstrated its effectiveness in 95.0% of patients. The appointment of the proposed drug of plant origin prevents the occurrence of recurrence in 97.5% of patients, which allows us to recommend it for use in order to prevent relapses of the disease.The use of the proposed preparation of herbal origin helps to reduce the feeling of incomplete emptying of the bladder, starting from 62.9±17.0 min and the disappearance of pollakiuria – by 179.7±23.0 min, which allows to make quick assess of phytotherapy effectiveness and, if necessary to strengthen it in time.