Cystitis

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Steven C. Campbell, M.D., Ph.D.

Treatment

Because of the risk of the infection spreading to the kidneys (complicated UTI) and due to the high complication rate in the elderly population and in diabetics, prompt treatment is almost always recommended.

Medication

Antibiotics are used to control bacterial infection. It is vital that one finish an entire course of prescribed antibiotics. Commonly used antibiotics include:

• Nitrofurantoin
• Trimethoprim-sulfamethoxazole
• Amoxicillin
• Cephalosporins
• Ciprofloxacin or levofloxacin
• Doxycycline

The choice of antibiotic should preferably be guided by the result of urine culture.

Chronic or recurrent UTI should be treated thoroughly because of the chance of kidney infection (pyelonephritis). Antibiotics control the bacterial infection. They may be required for long periods of time. Prophylactic low-dose antibiotics are sometimes recommended after acute symptoms have subsided.

Pyridium may be used to reduce the burning and urgency associated with cystitis. In addition, common substances that increase acid in the urine, such as ascorbic acid or cranberry juice, may be recommended to decrease the concentration of bacteria in the urine.

Monitoring

Follow-up may include urine cultures to ensure that bacteria are no longer present in the bladder.

Outcomes

Most cases of cystitis are uncomfortable but disappear without complication after treatment.

Possible complications

• Chronic or recurrent urinary tract infection
• Complicated UTI (pyelonephritis)
• Acute renal failure

Prevention

Keeping the genital area clean and remembering to wipe from front to back may reduce the chance of introducing bacteria from the rectal area to the urethra.

Increasing the intake of fluids may allow frequent urination to flush the bacteria from the bladder. Urinating immediately after sexual intercourse may help eliminate any bacteria that may have been introduced during intercourse. Refraining from urinating for long periods of time may allow bacteria time to multiply, so frequent urinating may reduce risk of cystitis in those who are prone to urinary tract infections.

Drinking cranberry juice prevents certain types of bacteria from attaching to the wall of the bladder and may lessen the chance of infection. Cranberry extract tablets have also been found to be effective in preventing cystitis, and avoid the taste of cranberry juice, which some find unpleasant.

External links

• Uncomplicated urinary infections: How do short and long courses of antibiotics compare?
• Interstitial Cystitis Network (ICN)
• Canada IC & OAB Resource Center
• Interstitial Cystitis Advice (A Patient Based Community for People with IC)

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