Which antibiotic for cystitis

Cystitis care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Diagnosis Female cystoscopy Open pop-up dialog box Close.

Female cystoscopy Cystoscopy allows your doctor to view your lower urinary tract to look for abnormalities, such as a bladder stone. Male cystoscopy Open pop-up dialog box Close. Male cystoscopy Cystoscopy allows your doctor to view your lower urinary tract to look for abnormalities in your urethra and bladder.

Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Kellerman RD, et al. Bacterial infections of the urinary tract in women. In: Conn's Current Therapy Elsevier; Accessed April 29, Bennett JE, et al. Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or urologic abnormalities.

Physical examination is typically normal or positive for suprapubic tenderness. A urinalysis, but not urine culture, is recommended in making the diagnosis. Urine cultures are recommended in women with suspected pyelonephritis, women with symptoms that do not resolve or that recur within two to four weeks after completing treatment, and women who present with atypical symptoms.

Urinary tract infections UTIs are the most common bacterial infections in women, with one-half of all women experiencing at least one UTI in their lifetime. Enlarge Print. The combination of new-onset frequency and dysuria, with the absence of vaginal discharge, is diagnostic for a urinary tract infection. A urine culture is recommended for women with suspected acute pyelonephritis, women with symptoms that do not resolve or that recur within two to four weeks after the completion of treatment, and women who present with atypical symptoms.

The history is the most important tool for diagnosing acute uncomplicated cystitis, and it should be supported by a focused physical examination and urinalysis. It also is important to rule out a more serious complicated UTI.

By definition, the diagnosis of acute uncomplicated cystitis implies an uncomplicated UTI in a premenopausal, nonpregnant woman with no known urologic abnormalities or comorbidities Table 1 5. Urologic abnormalities e. Information from reference 5. Classic lower urinary tract symptoms include dysuria, frequent voiding of small volumes, and urinary urgency. Sometimes hematuria can occur; suprapubic discomfort is less common.

The pretest probability of UTI in women is 5 percent; however, when a woman presents with the acute onset of even one of the classic symptoms of acute uncomplicated cystitis, the probability of infection rises fold to 50 percent. In addition, the likelihood of acute uncomplicated cystitis is less if the patient reports vaginal discharge or irritation, both of which are more likely in women with vaginitis or cervicitis.

The new onset of frequency and dysuria, with the absence of vaginal discharge or irritation, has a positive predictive value of 90 percent for UTI. For many patients, access to care can be difficult. Two recent studies have shown that some women who self-diagnose a UTI may be treated safely with telephone management. Women who have had acute uncomplicated cystitis previously are usually accurate in determining when they are having another episode. In one study of women with a history of recurrent UTI, 88 women self-diagnosed a UTI based on symptoms, and self-treated with antibiotics.

Another small, randomized controlled trial compared outcomes of acute uncomplicated cystitis in healthy women managed by telephone versus in the office. The authors concluded that the short-term outcomes of managing suspected UTIs by telephone were comparable with those managed by usual office care. The physical examination of patients with acute uncomplicated cystitis is typically normal, except in the 10 to 20 percent of women with suprapubic tenderness.

The convenience and cost-effectiveness of urine dipstick testing makes it a common diagnostic tool, and it is an appropriate alternative to urinalysis and urine microscopy to diagnose acute uncomplicated cystitis. Further studies beyond urinalysis and urine cultures are rarely needed to diagnose acute uncomplicated cystitis. Patients who present with atypical symptoms of acute uncomplicated cystitis and those who do not respond to appropriate antimicrobial therapy may need imaging studies, such as computed tomography or ultrasonography, to rule out complications and other disorders.

In , a panel of international experts updated the Infectious Diseases Society of America IDSA guidelines on the treatment of acute uncomplicated cystitis and pyelonephritis in women. The panel reviewed the literature, including the Cochrane Database of Systematic Reviews, and provided an evidence-based guideline for women with uncomplicated bacterial cystitis and pyelonephritis. Levels-of-evidence ratings were assigned to recommendations on the use of antimicrobials for the treatment of uncomplicated UTIs.

No single agent is considered best for treating acute uncomplicated cystitis according to the guidelines, and the choice between recommended agents should be individualized 16 Table 2 18 , Choosing an antibiotic depends on the agent's effectiveness, risks of adverse effects, resistance rates, and propensity to cause collateral damage i. Additionally, physicians should consider cost, availability, and specific patient factors, such as allergy history. On average, patients will begin noting symptom relief within 36 hours of beginning treatment.

Page last reviewed: 09 August Next review due: 09 August See a GP for advice and treatment if: you're not sure whether you have cystitis your symptoms don't start to improve within 3 days you get cystitis frequently you have severe symptoms, such as blood in your urine you're pregnant and have symptoms of cystitis you're a man and have symptoms of cystitis your child has symptoms of cystitis Women who have had cystitis before or who have had mild symptoms for less than 3 days don't necessarily need to see a GP, as mild cases often get better without antibiotics.

Things you can try yourself If you have had cystitis before and don't feel you need to see a GP, or had mild symptoms for less than 3 days, the following advice may help to relieve your symptoms until the condition clears up: take over-the-counter painkillers, such as paracetamol or ibuprofen always read the medicine information leaflet beforehand to check whether you can take it, and check with a pharmacist if you're not sure drink plenty of water this may help flush the infection out of your bladder and some people find it helpful, although it's not clear how effective it actually is don't have sex until you're feeling better as it may make the condition worse Some people believe drinking cranberry juice or using products that lowers the acidity of their urine such as sodium bicarbonate or potassium citrate reduces their symptoms, but there's a lack of evidence to suggest they're effective.

Antibiotics In some cases, a GP may prescribe a course of antibiotics. For some women, they'll be prescribed for 5 to 10 days. If cystitis keeps coming back If you keep getting cystitis recurrent cystitis , a doctor may prescribe stand-by antibiotics or continuous antibiotics.

Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Diagnosis Female cystoscopy Open pop-up dialog box Close. Female cystoscopy Cystoscopy allows your doctor to view your lower urinary tract to look for abnormalities, such as a bladder stone. Male cystoscopy Open pop-up dialog box Close. Male cystoscopy Cystoscopy allows your doctor to view your lower urinary tract to look for abnormalities in your urethra and bladder.

Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Wein AJ, et al. Infections of the urinary tract. In: Campbell-Walsh Urology.

Philadelphia, Pa. Accessed June 30, Ferri FF. Urinary tract infection. In: Ferri's Clinical Advisor Bladder infection urinary tract infection—UTI in adults.