Cystitis after childbirth treatment while breastfeeding

The occurrence and treatment of UTIS and cystitis in pregnancy and in lactating women

Changes in urinary tract during pregnancy makes a woman more susceptible to urinary tract infections during this period and in HS. The risks presented by the possibility of premature birth and child birth with low weight. Active examination of pregnant women with asymptomatic bacteriuria and subsequent treatment should be the absolute standard, because it can effectively reduce both the risk. The main groups of antibiotics used to treat urinary tract infections during pregnancy (as well as the treatment of cystitis nursing mothers) presented Cephalosporins I-III generation, and sometimes penicillin antibiotics. Contraindicated, especially Tetracyclines, Fluoroquinolones and Chloramphenicol. Treatment of asymptomatic bacteriuria or acute cystitis should last 5-7 days, treatment of acute pyelonephritis – up to 14 days. It is important to re-conduct inspections of urine.

Cystitis after childbirth, during pregnancy and during lactation

The most common symptomatic UTI during pregnancy and lactation is cystitis. Manifestations of the disease, as a rule, very similar to the symptoms of nonpregnant women, but in the later stages of pregnancy, symptoms may be less typical (for example, nonspecific pressure in the lower abdomen). After treatment of the acute infection, it is recommended to repeat the urine test on a monthly basis, because 10-20% of women have a recurrence of the infection during pregnancy or shortly after birth.

Treatment of cystitis during pregnancy usually lasts for 7 days. The drugs of first choice, as mentioned above, are the Penicillins and Cephalosporins I-III generations. The drug Ampicillin is not suitable because of the high incidence of resistant E. coli strains. In respect of a combination of antibiotics Penicillin with inhibitors of beta-lactamase ambiguous due to the small amount of available data, but despite this, their use in some cases is considered possible. On the application of another popular drug, Nitrofurantoin, there are two opinions. Some experts indicate that it is contraindicated in pregnancy, however, many other sources of Nitrofurantoin allow for use during 1-2 trimester. In the 3rd trimester of pregnancy the drug is contraindicated because of the risk of hemolytic anemia in the fetus. Nursing mother to take Nitrofurantoin should not!

Acute cystitis during lactation and pregnancy

Acute cystitis is the most common UTI during pregnancy and lactation. The symptoms of this disease include the following phenomena:

• Subfebrile.
• Dysuria.
• Pollakiuria.
• Sometimes incontinence.

Microscopic examination of urine is manifested proteinuria, leucocyturia, hematuria, culture shows significant bacteriuria (defined as at least 103 CFU (kolonialismus units colony forming units) of pathogenic bacteria per milliliter of urine). Treatment of acute cystitis need with consideration of sensitivity to antibiotics, which can be used during pregnancy and lactation. First of all, are introduced:

• Amoxicillin (500 mg every 8 hours), possibly in combination with inhibitors of lactamases.
• Cefuroxime (250 mg every 12 hours) for 5 to 7 days.

You should always verify the success of re-treatment studies. If recurrences of UTI during pregnancy, you need to enter maintenance treatment is one of drugs such as:

• Cephalexin (125-250 mg).
• Cefaclor 250 mg.
• Nitrofurantoin (50 mg).

Medications taken at night or after intercourse.

Antibiotics during pregnancy

The distribution of antibiotics depending on their fitness during pregnancy, subject to various classifications. The views are the same only in respect of classification of Penicillin and Cephalosporin, which are generally regarded as safe. In many other cases, views and recommendations differ significantly. Pharmaceuticals asa rule, is contraindicated during pregnancy include:

1. Tetracycline.
2. Fluoroquinolones.
3. Chloramphenicol.
4. Trimethoprim (especially during 1st trimester).
5. Sulfonamides (particularly in last trimester).

Possible treatment of acute UTIS for women outside of pregnancy (!) are also products of plant origin (mainly of a mixture for tea) with variable composition. They are considered as dietary supplements and their use during pregnancy there are many contradictory opinions. Here is some information about the use of cranberry (in fruit or juice) during pregnancy without evidence of adverse effects. However, before taking any remedies (pharmacological or herbal) you should consult with a doctor!

Antibiotic therapy and cystitis – treatment while breastfeeding

With regard to antibiotic treatment during lactation, the doctor usually recommends medicines that are contraindicated during this period:

• Nitrofurantoin.
• Chloramphenicol.
• Tetracycline.
• Metronidazole.
• Sulfamethoxazole.
• Piperacillin.
• Roxithromycin.
• Ethambutol.
• Pyrazinamide.

On the contrary, to safe antibiotics during HS are:

• Penicillins.
• Cephalosporins.
• Gentamicin.
• Macrolides.
• Azithromycin.
• Roxithromycin.

However, despite the fact that these antibiotics can be used during lactation, they may induce allergic reactions or diarrhea.

Cystitis treatment while breastfeeding – risks and benefits

The penetration of antibiotics in breast milk can affect your baby as well as and adults, including the emergence of drug allergies or dysbiosis induced by antibiotics. Penetration of antibiotic in the breast milk depends on several factors, most important of which are:

• The molecular size.
• Degree of ionization.
• Binding to plasma or milk proteins.

The impact on children depends, in addition to the concentration of antibiotics in milk, frequency of lactation and the duration of the period between the introduction of antibiotics and feeding. Maximum appropriate antibiotics while breastfeeding considered to Cephalosporins and Penicillins. Acceptable also Macrolides, Trimethoprim, and Aminoglycosides (from the gastrointestinal tract of the baby they are not absorbed in sufficient quantity).

Cotrimoxazole should not be taken during the first 2 months of a child's life, as it can lead to increased bilirubin levels or development of hemolytic anemia.

Inappropriate and even contraindicated:

1. Doxycycline (fat-soluble + the risk of metabolic disorders of bones and teeth).
2. Fluoroquinolones (fat-soluble + the risk of joint damage, as demonstrated in animal studies).
3. Nitrofurantoin during the first 3 months of life the child (risk of hemolytic anemia).

Cystitis treatment while breastfeeding – is it necessary to interrupt GW

If necessary, antibiotic treatment of urinary tract infections in breastfeeding to reduce adverse effects on the child and eliminating the need to interrupt feeding is advisable:

1. To breastfeed immediately before taking the next dose of antibiotics.
2. When taking the drug once a day, take the antibiotic before the longest anticipated length of breastfeeding.
3. Possible substitute for breast milk during the highest expected concentrations.

In most cases there is no need to interrupt breastfeeding.

Treatment of cystitis during pregnancy and pregnancy – conclusion

Urine test in the 1st trimester of pregnancy is an absolutely essential part of care for pregnant women. In the case of a positive result must be repeated examination to exclude the possibility of error and unnecessary introduction of therapy.

In the case of performance criteria of asymptomatic bacteriuria requires treatment and follow-up.

Currently the choice of drugs provides effective therapy of asymptomatic ailments and symptomatic urinary tract infections during pregnancy and lactation, while minimizing the risk to the fetus.

Preferred groups of drugs are Cephalosporins I-III generations and Penicillins. Special attention during pregnancy and lactation should be paid to the use of herbal preparations, because almost all of them lack the relevant studies proving their safety.