Cystitis Health Article

Medications

Uncomplicated cystitis is treated with antibiotics. These include penicillin, ampicillin, and amoxicillin; sulfisoxazole or sulfamethoxazole; trimethoprim; nitrofurantoin; cephalosporins; or fluoroquinolones. (Flouroquinolones are generally not used in children under 18 years of age.) Treatment for women is short-term; most patients respond within three days. Men do not respond as well to short-term treatment and require seven to 10 days of oral antibiotics for uncomplicated UTIs.

Patients of either sex may be given phenazopyridine or flavoxate to relieve painful urination.

Trimethoprim and nitrofurantoin are preferred for treating recurrent UTIs in women.

Over 50% of older men with UTIs also suffer from infection of the prostate gland. Some antibiotics, including amoxicillin and the cephalosporins, do not affect the prostate gland. Fluoroquinolone antibiotics or trimethoprim are the drugs of choice for these patients.

Patients with pyelonephritis can be treated with oral antibiotics or intramuscular doses of cephalosporins. Medications are given for 10–14 days, and sometimes longer. If the patient requires hospitalization because of high fever and dehydration caused by vomiting, antibiotics can be given intravenously.

Surgery

A minority of women with complicated UTIs may require surgical treatment to prevent recurrent infections. Surgery is also used to treat reflux problems (movement of the urine backwards) or other structural abnormalities in children and anatomical abnormalities in adult males.

Alternative treatment

Alternative treatment for cystitis may emphasize eliminating all sugar from the diet and drinking lots of water. Drinking unsweetened cranberry juice not only adds fluid, but is also thought to help prevent cystitis by making it more difficult for bacteria to cling to the bladder wall. A variety of herbal therapies are also recommended. Generally, the recommended herbs are antimicrobials, such as garlic (Allium sativum), goldenseal (Hydrastis canadensis), and bearberry (Arctostaphylos uva-ursi), and/or demulcents that soothe and coat the urinary tract, including corn silk and marsh mallow (Althaea officinalis).

Homeopathic medicine can also be effective in treating cystitis. Choosing the correct remedy based on the individual's symptoms is always key to the success of this type of treatment. Acupuncture and Chinese traditional herbal medicine can also be helpful in treating acute and chronic cases of cystitis.

BOOKS

Anderson, E. Everett. "Dysuria, Pyuria, and Hematuria." In Current Diagnosis. Vol. 9. Ed. Rex B. Conn, et al. Philadelphia: W. B. Saunders Co., 1997.

Donovan, James F., and Richard D. Williams. "Urology." In Current Surgical Diagnosis and Treatment. 10th ed. Ed. Lawrence W. Way. Stamford: Appleton & Lange, 1994.

"Genitourinary Disorders: Lower Urinary Tract and Male Genital Tract Infections." In The Merck Manual of Diagnosis and Therapy. 16th ed. Ed. Robert Berkow. Rahway, NJ: Merck Research Laboratories, 1992.

King, Lowell R. "Bacterial Infections of the Urinary Tract in Girls." In Conn's Current Therapy, 1996, ed. Robert E. Rakel. Philadelphia: W. B. Saunders Co., 1996.

"Lower Urinary Tract Infection." In Professional Guide to Diseases, ed. Stanley Loeb et al. Springhouse, PA: Spring-house Corporation, 1991.

Mata, John A. "Bacterial Infections of the Urinary Tract in Females." In Conn's Current Therapy, 1996, ed. Robert E. Rakel. Philadelphia: W. B. Saunders Co., 1996.

Robertson, Jack R., and David B. Hebert. "Gynecologic Urology." In Current Obstetric & Gynecologic Diagnosis & Treatment, ed. Alan H. DeCherney and Martin L. Pernoll. Stamford: Appleton & Lange, 1994.

Rebecca J. Frey

KEY TERMS

Bacteriuria—The presence of bacteria in the urine.

Dysuria—Painful or difficult urination.

Hematuria—The presence of blood in the urine.

Pyelonephritis—Bacterial inflammation of the upper urinary tract.

Urethritis—Inflammation of the urethra, which is the passage through which the urine moves from the bladder to the outside of the body.