Standby antibiotic treatment for women who are prone to cystitis and have been diagnosed with recurrent cystitis by their GP or doctor

Cystitis is the medical term for inflammation of the bladder. Most of the time, the inflammation is caused by a bacterial infection, and is known as a urinary tract infection (UTI). A bladder infection can be painful and annoying, and it can become a serious health problem if the infection spreads to your kidneys.

Cystitis in women is common with some women being prone to repeated episodes of cystitis. A short course of antibiotics, along with education around transmission of germs, is the usual treatment. Men rarely suffer from cystitis and the treatment offered here is not for men. Cystitis clears quickly without complications in most cases.

Causes

The germs that usually cause these infections live in your large intestine and are found in your stool. If these germs get inside your urethra, they can travel up into your bladder and kidneys and cause an infection.
Women are eight times more likely to have cystitis than men, as the tube that passes out urine from a woman's bladder (the urethra) is shorter and opens nearer the back passage (anus).
Up to 15% of women have cystitis each year and about half of women have at least one bout of cystitis in their life.
Risk factors for cystitis include having diabetes, being pregnant and being sexually active. Less commonly, cystitis may occur as a reaction to certain drugs, radiation therapy or potential irritants, such as feminine hygiene spray, spermicidal jellies or long-term use of a catheter.

Cystitis Symptoms

Urine is usually free from bacteria. In cystitis, bacterial infection in the urine causes irritation in the bladder, leading to burning when passing water and, usually, a need to run to the toilet frequently. There may also be an offensive smell to the urine which may be cloudy and blood stained.

Complications

Cystitis is not normally a serious condition, however occasionally infection can travel up into the kidneys leading to a serious infection known as pyelonephritis.

Pyelonephritis is infection in the kidneys that can cause kidney damage. The symptoms of pyelonephritis are: high fever, back ache, shivering, headache, nausea and vomiting. Pyelonephritis requires urgent medical attention and sometimes hospital treatment.

Recurrent Cystitis

Most urinary infections seem to start for no particular reason. If a woman has repeated episodes of cystitis, and the pattern of infection and symptoms are not changing, doctors usually treat each infection as it arises with antibiotics.

Doctors often cannot find out why a woman is getting repeated episodes of cystitis. When a woman first starts having these infections, tests are sometimes carried out to rule out more serious underlying causes. The tests usually come back normal.

In some women cystitis is associated with recent intercourse or can be associated with stress. The vast majority of women improve within a few days of developing cystitis. However, if your symptoms do not improve despite taking antibiotics then you may need an alternative antibiotic. Some germs (bacteria) causing cystitis can be resistant to some types of antibiotic.

Treatment of Cystitis

A short course of antibiotics will normally cure cystitis. Trimethoprim usually cures over 90% of urine infections, although cure rates differ over time and in different parts of the country.

When Trimethoprim is ineffective, or not suitable, other antibiotics can be tried. Although it has been said that drinking lots of water may be helpful, there is little evidence for this. Drinking lots may just cause more (painful) toilet trips! A normal amount of fluid intake should be sufficient.

Potassium citrate may help relieve the discomfort in mild cystitis. It works by making the urine less acidic. It can be bought without a prescription at pharmacies.

Other antibiotics commonly used to treat cystitis include ciprofloxacin, co-amoxiclav (Augmentin), and nitrofurantoin. These antibiotics are sometimes used as first choice or as an alternative to trimethoprim. They are not available from MyClinic.

The usual treatment for bacterial cystitis is antibiotics. Treatment for other types of cystitis depends on the underlying cause. The treatment offered by MyClinic is for those women who suffer have a diagnosis of recurrent cystitis and have been investigated for potential underlying causes by their GP or regular doctor.

Prevention

Drinking plenty each day may help to reduce infections. Emptying the bladder after intercourse can help for women who tend to get infections within a day or so after having sex. Wiping from front to back after toileting may also prevent transmission of bacteria from the anus to the urethra. Wear cotton underwear and change daily, and do not wear tight-fitting trousers or tights - this avoids warm, moist air around your genitals, which some types of bacteria thrive in. These simple measures are common-sense approaches that may be helpful in preventing infection in some women.

Proceed to important information about Cystitis

Dr Terry Deeny

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