Antibiotics Effective For Adnexitis: Pros And Cons

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Antibiotics for adnexitis: pros and cons

The causative agents of adnexitis are pathogenic bacteria that have penetrated the ovaries or fallopian tubes. They enter the body sexually or are brought with the bloodstream from other foci of infection. For effective treatment of the inflammatory process, antibacterial drugs of a wide spectrum of action are prescribed.

Content:

• Approach to the treatment of adnexitis with antibiotics
• Review of the most popular antibiotics for adnexitis
• Why are antibiotics necessary for adnexitis?
• Additional treatments for acute adnexitis
• What antibiotics can be taken with adnexitis during pregnancy?
• Indications for surgical treatment of adnexitis

Approach to the treatment of adnexitis with antibiotics

It is very important when prescribing antibacterial agents to avoid the resistance of pathogenic bacteria to them. The wrong choice of drugs can postpone the period of complete recovery from adnexitis or lead to its transition to a chronic form.

Antibiotic selection rules:

• Before starting treatment, it is required to establish the exact cause of the infection. Different types of pathogenic bacteria react differently to antibacterial agents.
• Before choosing a medicine, the doctor prescribes a bacterial analysis of the flora for sensitivity to antibiotics.
• It is required to take into account the peculiarities of the course of the inflammatory process. At the onset of the disease, a woman needs emergency help, after determining the type of pathogen, the prescribed treatment is corrected.
• Before treating the chronic form of adnexitis, it is imperative to establish the sensitivity of the microflora to antibiotics, and only then select the desired drug, since in this case the infection is often mixed.

• The choice of dosage form depends on the stage of the disease. The acute course of adnexitis is treated with injections of antibacterial drugs. After stabilizing the patient's condition and restoring the blood count, oral medication is recommended. Treatment of the chronic form of the disease begins immediately with taking pills.
• Antibiotic therapy is complemented in severe and advanced cases by the appointment of vaginal suppositories and physiotherapy procedures.

The course of antibiotic treatment is usually 10-14 days. It is unacceptable to interrupt it even after a significant improvement in well-being and after the symptoms of the disease have already disappeared. Without consulting your doctor, you cannot spontaneously replace drugs.

Review of the most popular antibiotics for adnexitis

The antibiotics used for adnexitis have both positive and negative properties.

Azithromycin

Belongs to the group of macrolides, it is effective against most bacteria that cause adnexitis. The duration of the course of treatment depends on the type of pathogen and varies from one day to 1.5 weeks.

Pros of using Azithromycin:

• Effective against bacterial infection;
• Well tolerated by patients;
• Side effects are very rare and quickly disappear when the drug is discontinued;
• With restrictions, it can be used during pregnancy;
• It is applicable in the treatment of adnexitis caused by atypical intracellular pathogens such as chlamydia and mycoplasma;
• Quickly creates a high concentration in body tissues and keeps it for a long time;
• Does not decompose in the acidic environment of the stomach, does not violate gastrointestinal motility;
• Increases the sensitivity of resistant microbes to the action of other antibiotics;
• It has a postantibiotic effect, therefore it can be used in short courses.

Cons - when using high doses, the drug can cause:

• Diarrhea;
• Visual impairment;
• Lymphocytopenia;
• Nausea and vomiting.

Doxycycline

Belongs to the group of tetracyclines, is used against gram-negative bacteria and opportunistic flora (Escherichia coli, enterococcus). For the treatment of adnexitis, a combination of Doxycycline with Gentamicin is used. The course of treatment is 14 days (2 times a day, 0.2 g).

Pros of using Doxycycline:

• The drug is very cheap (about 20 rubles);
• Perfectly absorbed;
• Possesses high therapeutic activity;
• Works regardless of food intake.

Minuses:

• Not applicable during pregnancy and lactation;
• May provoke headache, dizziness, itching, skin rash, dermatitis, digestive system disorders;
• Requires drinking a whole glass of water, very often causes nausea and vomiting after ingestion;
• When combined with retinol, it increases intracranial pressure.

Augmentin

Belongs to the group of protected aminopenicillins, contains a combination of amoxicillin and clavulanic acid. The course of treatment lasts from 5 to 21 days, depending on the type of pathogen.

Pros of using Augmentin:

• Effective against a wide range of pathogens - gram-negative and gram-positive aerobic bacteria;
• For the treatment of adnexitis, various forms of the drug (injections, tablets, suspension) can be used;
• Has a prolonged action;
• Allowed for breastfeeding and (in rare cases) in the last trimester of pregnancy.

Minuses:

• Contraindicated in liver diseases, hypersensitivity to penicillins;
• May cause thrush, diarrhea, nausea and vomiting;
• In case of an overdose, disorders of the digestive tract and water-salt balance occur.

Tsiprolet

Belongs to the group of fluoroquinolones, the active ingredient is ciprofloxacin, it is effective as an agent against gram-positive and gram-negative bacteria, as well as against opportunistic and anaerobic microbes. The course of treatment with Tsiprolet takes 10-14 days, the dosage is 2 times a day for 0.5 g.

Advantages of using the drug:

• Effective even against protozoa (Trichomonas, lamblia, amoeba) and anaerobic bacteria;
• It is quickly and well absorbed in the digestive tract;
• Does not disturb the balance of the vaginal microflora.

Minuses:

• Not used during pregnancy and lactation;
• It has a large number of contraindications and side effects;
• In case of an overdose, convulsions and disruption of the urinary system are possible;
• When interacting with ultraviolet rays, the development of photosensitization is not excluded.

Nolitsin

The main active ingredient of the drug is norfloxacin, which destabilizes the DNA of pathogenic microorganisms and thereby causes their death. Nolitsin is a specific drug for the treatment of pathologies of the genitourinary system.

Pros of using Nolitsin:

• It is rapidly absorbed in the digestive system;
• Has a long lasting antimicrobial effect;
• Has a low cost.

Minuses:

• Do not use during pregnancy;
• May cause atherosclerotic changes in the vessels of the brain;
• Able to provoke an allergic reaction;
• Side effects include kidney dysfunction, nausea, vomiting, loss of appetite,
• When combined with alcohol, it can cause liver dysfunction.

Gentamicin

The drug is from the aminoglycoside group, the most effective against aerobic gram-negative bacteria. Acts on the cytoplasm of the cells of microorganisms. Useless against anaerobes and protozoa. It is used in the form of a solution for injection and in the form of tablets.

Pros of using Gentamicin:

• Microbial resistance to the drug develops slowly;
• The drug is absorbed quickly and fully;
• The drug is offered to consumers at a low cost.

Minuses:

• Not used during pregnancy and lactation;
• Sometimes soreness is felt with the introduction;
• With prolonged use, nephrotoxicity is observed;
• In case of an overdose, there is a decreased neuromuscular conduction, complicated by respiratory arrest;
• When taking the drug, nausea, vomiting, drowsiness, hearing impairment, and an allergic reaction may occur.

Sumamed

The main active ingredient of the drug is azithromycin dihydrate. Sumamed is a bacteriostatic antibiotic from the group of azalide macrolides. The drug disrupts the protein synthesis of the cells of pathogenic bacteria and thereby stops their growth and reproduction. Sumamed is active against intracellular pathogens and many gram-positive and gram-negative bacteria.

Pros of using Sumamed:

• It is rapidly absorbed and distributed in the body;
• Easily penetrates cell membranes, concentrates in the focus of infection;
• Can be used in short courses of 1-3 days with a single dose of the drug during the day.

Minuses:

• Over time, bacteria develop resistance to the drug;
• It has a large number of side effects - disturbances in the activity of the nervous, digestive and cardiovascular systems, organs of vision and hearing, liver and hematopoietic system, allergic manifestations;
• In case of overdose, short-term hearing loss, diarrhea, nausea and vomiting are noted.

Why are antibiotics necessary for adnexitis?

The course of adnexitis can be complicated by infertility, the occurrence of an ectopic pregnancy, and the development of adhesions. Adhesions in the pelvic organs lead to stagnation due to deterioration of the blood supply to the reproductive system, to the appearance of frequent pains that violate the harmony of intimate relationships.

The high rate of spread of infection, the severity and frequency of complications requires the mandatory use of antibacterial agents. Independent use of antibiotics and suppositories with antimicrobial effect is unacceptable. Only a doctor can take into account the features of the disease, symptoms of the inflammatory process and prescribe the most effective antibacterial agent for relieving pain and temperature.

If adnexitis is caused by a sexually transmitted infection, the woman's partner also needs examination and treatment.

Additional treatments for acute adnexitis

Antibiotic treatment is always combined with detoxification of the body from the waste products of microorganisms.

Additional treatment methods:

• Infusion of glucose solutions, hemodesis, rheopolyglucin, physiological solutions and protein preparations;
• Use of analgesics;
• The introduction of suppositories with proteolytic and anti-inflammatory components;
• Physiotherapy - electrophoresis with copper, magnesium, calcium;
• Spa treatment.

What antibiotics can be taken with adnexitis during pregnancy?

When treating adnexitis in women expecting the birth of a child, the following groups of antibacterial drugs are excluded:

• Lincosamides (Clindamycin);
• Fluoroquinolones (Ciprofloxacin, Ofloxacin);
• Tetracyclines (Doxycycline);
• Aminoglycosides (Gentamicin).

Since Metronidazole is included in many treatment regimens for adnexitis, it must be remembered that it is prohibited to take it in the first three months of pregnancy. In the treatment of inflammation of the appendages in the 2nd and 3rd trimester, this drug is prescribed only by the decision of the doctor.

For adnexitis caused by chlamydia, the following antibiotics are used:

• Erythromycin;
• Josamycin;
• Spiramycin.
• Azithromycin.

Amoxicillin is chosen as an alternative to the above drugs.

Indications for surgical treatment of adnexitis

In difficult cases of adnexitis, there may be indications for surgery:

• Suspected ovarian cyst or tumor;
• Development of a purulent process (ovarian abscess, tubo-ovarian abscess, pyosalpinx);
• Changes in the anatomy and normal functioning of the appendages;
• Lack of effect from drug therapy;
• The combination of a chronic form of adnexitis with endometriosis;
• Extensive adhesive process with pain syndrome.

At the initial stages of the disease, diagnostic laparoscopy is used with the treatment of the abdominal cavity with antiseptic solutions. If the course of adnexitis is complicated by an adhesive or purulent process, the presence of ovarian cysts and tumors, uterine myoma, extensive surgical intervention is performed. The risk of infertility remains even after the correct restoration of tubal patency and the elimination of adhesions.

The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist

Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.