Monday , June 27 2022

Prescribing Cystitis and curative drugs: Aifa brakes on the use of specific antibiotics


The term change often means the emergence of a whole series of disorders: in the female population systitis phenomena are rare. Indeed, they are highlighted by lowering the immune defenses and sudden changes in temperature, due to natural anatomical predisposition to the development of cystitis or to the lower urinary tract bladder wall infections often supported by bacteria.

The sudden changes in temperature, sweating or sudden cooling always highlight the risk of bronchitis or inflammation of the airways of a higher and medium level. Whether it is cystitis or our bronchitis, treatment is often on the basis of antibiotics.


AIFA has recently noted in a note that the ciprofloxacin, lefofxxin, moxifloxacin, pefloxacin, prulifloxacin, rufloxacin, norfloxacin, lomefloxacin, belonging to quinolone and fluoroquinolone families are prescribed very carefully so that they can induce, t as well as known adverse reactions to the musculoskeletal system and nervous system, the emergence of severe pathologies affecting the aorta.

The AIFA has also decided to remove medications that include cinoxacin, flumechin, nalidixic acid and pipemidic acid that includes an operation mechanism similar to fluorocinolons.

«AIFA's decision was reached in agreement with the European Medicines Agency (EMA) after three separate epidemiological studies carried out in Canada, Taiwan and Sweden showed an increased risk of aneurysm and the distribution of aorta in vulnerable patients with fluorocinolons. It 's probably the mechanism that' s the basis of these unfavorable reactions is the mechanism that determines the risk of tenders. Shredding is a reduction in the connective tissue collagen content leading to the weakening of the ship's wall. The spontaneous frequency of these pathologies is very low (about 3-30 cases per 100.00 people per year) and the fluorocinolons would increase it according to the studies of 66-150%. – explains Roberto Padrini, a professor of pharmacology at the University of Padua who also explains – These recent reports so suggest not to use these drugs for mild infections that would also improve without antibiotics or can respond to other antibiotics and even to patients who have already had adverse fluorocinolon reactions, particularly in the presence of predisposition factors, such as higher age failure, kidney failure or concomitant use of corticosteroids. So, patients have to be aware of this risk and the need to seek immediate medical attention if they suffer chest pain or the abdomen suddenly.

Common use of drugs included in the AIFA note

Many of the active ingredients are highlighted in the note that AIFA has been used for decades, precisely for the treatment of cystitis and bronchitis. It is no coincidence that the AIFA note has invited all prescribers not to use these drugs for treating minor or self-limiting infections such as pharyngitis, tonsillitis and acute bronchitis; for the prevention of passenger diarrhea or lower urinary tract infections; for mild to moderate infections including simple cystitis, severe exacerbation of chronic bronchitis and chronic obstructive pulmonary disease – COPD, acute bacterial rhinosinuster and acute dois media, unless other commonly recommended antibiotics for these infections are considered inappropriate .

How the GP should behave

"In Italy unfortunately there is abuse of antibiotics and also quinolons and fluoroconons, with various data from the region and the region, but anyway it is essential that all doctors review their prescribing habits. T Alessandro Rossi, a member of the General Medical Association of Italy and responsible for the antibiotic resistance, said carefully. Often, the general practitioner is the first to consult with and to deal with patients for the diseases that are being treated so far. «The AIFA note calls on each prescriber to carefully evaluate the drug therapy he / she intends to prescribe. it is good to remember that in the face of uncomplicated acute cystitis, it is not necessary to resort to quinolone or fluorocinolon is enough to recommend correct hydration and prescribe antibiotics based on joint trimoxazole or phosfomycin. On the other hand, if the infection is complicated, it is not impossible to prescribe quinolone antibiotics, but the actual usability must be assessed on a case by case basis.

There is no scary then, but only so much common sense with Dr Rossi comes to the conclusion: "The same argument is also valid for bronchitis, if there are no complications at all there are antibiotics In contrast, pharyngitis or tonsillitis should not be treated with quinolone or fluorocinolon, in the case of important complications, on the other hand, their use is often indispensable, even this case the doctor's experience is essential to solve the problem correctly ".

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