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10.5: Cystitis

  • Page ID
    15630
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    Clinical Presentation

    • frequency and urgency
    • suprapubic and back pain
    • dysuria
    • no pyrexia
    • elderly patients may present with sudden onset of incontinence and/or smelly urine

    Treatment

    Three day course of treatment is sufficient to eliminate uncomplicated cystitis completely Single dose therapy only 70% effective.

    Agents used:

    • Fluoroquinolones
    • Co-amoxiclav
    • Cephalosporins
    • Nitrofurantoin

    Recurrent Cystitis

    • recurrent cystitis in females is very common and is usually reinfection

    General Measures

    • good fluid intake
    • local hygiene
    • sexual intercourse
    • avoid before and after intercourse
    • avoid spermicidal creams and diaphragm contraceptives
      • topical oestrogens for atrophic vaginitis
      • treat constipation

    Specific Measures

    Three options:

    1. Continuous low dose chemoprophylaxis Nitrofurantoin, Cephalosporin nocte dose for 6-9 months
    2. Post intercourse single dose therapy if UTIs related to intercourse. Antimicrobials as above
    3. “Self-start” Therapy. Patient has supply of treatment (usually Fluoroquinolone), when symptoms of cystitis begin send urine specimen for culture and initiate therapy, attend doctor few days later when culture result available.

    This page titled 10.5: Cystitis is shared under a CC BY-NC-SA 2.5 license and was authored, remixed, and/or curated by Stephen Jeffery and Peter de Jong via source content that was edited to the style and standards of the LibreTexts platform.