Because of the risk of the infection spreading to the kidneys and due to the high complication rate in the elderly population and in diabetics, prompt treatment is almost always recommended. It is advised to avoid vaginal penetration until the infection has cleared up.
Medication
Antibiotics are used to control bacterial infection. It is vital that a course of antibiotics, once started, be completed. Cystitis can also be treated with over-the-counter medicines, where self-treatment is appropriate.
Commonly used antibiotics include:
- Nitrofurantoin
- Trimethoprim-sulfamethoxazole
- Amoxicillin
- Cephalosporins
- Ciprofloxacin or levofloxacin
- Doxycycline
The choice of antibiotic should preferably be guided by the result of urine culture.
Chronic or recurrent UTI should be treated thoroughly because of the chance of kidney infection (pyelonephritis). Antibiotics control the bacterial infection. They may be required for long periods of time. Prophylactic low-dose antibiotics are sometimes recommended after acute symptoms have subsided.
Pyridium may be used to reduce the burning and urgency associated with cystitis.
There is some evidence that making the urine either more acidic (e.g. with ascorbic acid) or more alkaline may calm the pain of cystitis. Cranberry juice also contains condensed tannins, Mannose - D and proanthocyanidins which have been found to inhibit the activity of E. coli by preventing the bacteria from sticking to mucosal surfaces lining the bladder and gut, helping to clear bacteria from the urinary tract.
Follow-up may include urine cultures to ensure that bacteria are no longer present in the bladder.
Further Reading
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"Cystitis"
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