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Cystitis

How Is Cystitis Treated?

Last updated on:
21/03/2012

Contributing Author: Guy Slowik FRCS

Cystitis is almost always treated with medication.

These medications include:

Surgery is rarely used to treat cystitis. It can occasionally be useful for treating people with interstitial cystitis.

Surgery also can be useful for correcting an underlying structural blockage or abnormality that is causing recurring cystitis.

Oral Antibiotics

Oral antibiotics are the most common medications used to treat cystitis. They kill the bacteria that are causing the infection.

  • Symptoms usually disappear within a few days, and further tests probably will be unnecessary.
  • If symptoms continue beyond that time or increase in severity, check with the doctor.
  • Some experts say that any woman with persistent symptoms of cystitis should receive antibiotics, even if the urine shows low-to-normal bacteria counts.

Nice To Know:

Tips on taking antibiotics:

  • Take exactly as directed.
  • Be sure to finish taking all of the antibiotic prescribed. Not completing the course of treatment can let the bacteria regrow and become resistant to the drug.
  • If you are pregnant or suspect you are, make sure your health care provider knows.
  • Take the drug at bedtime to help it work the most effectively.

Many experts worry that widespread use of antibiotics causes them eventually to become ineffective. That happens when bacteria that certain antibiotics used to kill quickly become resistant to these medications.

Penicillin and sulfa drugs were once common treatments for cystitis. Today, about a third of bacterial strains causingurinary tract infections have become resistant to these medications.

Because bacterial resistance is increasing for other antibiotics, as well, your health care professional may change the usual antibiotic treatment regimen.

Antibiotics often used to treat cystitis include:

  • Amoxicillin
  • Sulfa drugs (sulfonamides)
  • Cephalosporins
  • Nitrofurantoin
  • Doxycycline
  • Trimethoprim-sulfamethoxazole

People with serious recurring or chronic cystitis need thorough treatment because of risk for kidney infection.

  • Your doctor may recommend long-term antibiotic therapy and request a urine culture.
  • Sometimes stronger-than-normal antibiotics may prove useful.
  • Combinations of drugs also may work.

Painkillers

Pain-relieving drugs help treat symptoms of burning and urgency. They may be available over-the-counter (often called OTC drugs) or by prescription only.

Painkillers do not cure the infection causing cystitis.

  1. Phenazopyridine is a prescription drug in the United States used specifically to relieve painful urination. U.S. brands include Azo-Standard, Eridium, Geridium, Pyridium, and Urogesic. In Canada, it is available without a prescription, and brands include Phenazo and Pyridium.

    Phenazopyridine turns urine red to bright orange, which can stain clothing. Urine returns to normal color when the drug is stopped.

    Nice To Know:

    To use phenazopyridine:

    • Take with food to reduce chances of stomach upset.
    • Discard any leftover drug. Do not use for future attacks.
    • Do not store in damp places. Heat or moisture can break down the medicine.
    • Check with the doctor if symptoms worsen.
    • Do not take phenazopyridine if you wear soft contact lenses. The drug can permanently discolor or stain the lenses.
    • If you are diabetic, be aware that phenazopyridine may cause false urine test results, both for urine sugar and urine ketone. Check with the doctor before taking this drug.
  2. Aspirin (OTC). Aspirin often can relieve the pain and discomfort of cystitis.

    Need To Know:

    Caution: Never give aspirin to children or teenagers, unless directed by a doctor. Aspirin is associated with a condition calledReye's syndrome, which can be fatal.

  3. Acetaminophen (OTC). Although acetaminophen does not relieve inflammation, it is relatively free of the side effects that sometimes occur with some other painkillers. Brands include Tylenol, Panadol, and Tempra.
  4. Ibuprofen (OTC). Brands include Advil and Motrin.
  5. Naproxen sodium (OTC). Brands include Aleve and many store-name brands.

How To Information:

Which Pain Reliever is Best for You?

With so many over-the-counter pain relievers in the stores, it is hard to know which one is best. Facts to keep in mind:

  • Almost all OTC pain relievers contain one of five common ingredients: aspirin, acetaminophen, ibuprofen, naproxen sodium, and ketoprofen.
  • Few differences exist among them.
  • All relieve minor pain and reduce fever.
  • Some also reduce inflammation (aspirin, ibuprofen, naproxen sodium).
  • Some of these products (aspirin, ibuprofen, naproxen sodium and ketoprofen) are called NSAIDs. You should be aware of side effects, particularly erosions or ulcers that can occur in the stomach and cause significant bleeding. This side effect can be minimized by taking the medication with meals or soon thereafter. The new Cox 2 inhibitors (Celebrex andVioxx) are less likely to cause these side effects but they are much more expensive.
  • Take painkillers with milk and food to help prevent stomach upset.

Nice To Know:

General precautions:

  • If you take other medicines, discuss which painkiller is best for you with your doctor or pharmacist.
  • Never take more than what the package label or your doctor recommends.
  • Don't drink alcohol. Drinking while taking NSAIDs can increase chances of stomach upset and bleeding. Drinking and taking too much acetaminophen can seriously damage your liver.

Antispasmodics

These prescription-only medicines help decrease the muscle spasms that cause urgency to urinate. Some of the most commonly used are:

  • Tolterodine (brand name Detrol)
  • Flavoxate (brand name Urispas)
  • Oxybutynin (brand name Ditropan)

Nice To Know:

Best ways to use antispasmotics:

  • Take exactly as directed.
  • Make sure the doctor knows if you are pregnant or nursing.
  • Make sure the doctor knows if you are diabetic.
  • Discuss all medical conditions with your doctor before taking.
  • Inform the doctor of all other medications you are taking (including all OTC and prescription drugs).

 

 
 

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.