Cystitis
Jump to navigation
Jump to search
Cystitis is defined as "inflammation of the urinary bladder, either from bacterial or non-bacterial causes. Cystitis is usually associated with painful urination (dysuria), increased frequency, urgency, and suprapubic pain."[1]
Diagnosis
A clinical prediction rule suggests that if a patient has at least two of 1) dysuria, 2) the presence of more than trace leukocytes, 3) or the presence of nitrites, the diagnosis is sufficiently likely to consider empirical treatment.[2]
Treatment
For uncomplicated cystitis, nitrofurantion 100 mg by mouth twice a day for 5 days may be used.[3]
Prevention
The following are measures that studies suggest may reduce the incidence of urinary tract infections. These may be appropriate for people, especially women, with recurrent infections:
- Cleaning the urethral meatus (the opening of the urethra) after intercourse has been shown to be of some benefit; however, whether this is done with an antiseptic or a placebo ointment (an ointment containing no active ingredient) does not appear to matter.[4]
- Cranberry juice may decrease the incidence of cystitis according to a systematic review of randomized controlled trials by the Cochrane Collaboration. The Cochrane concluded 'some evidence from trials to show cranberries (juice and capsules) can prevent recurrent infections in women. Many people in the trials stopped drinking the juice, suggesting it may not be a popular intervention'.[5]
- For post-menopausal women, a randomized controlled trial has shown that intravaginal application of topical estrogen cream can prevent recurrent cystitis.[6] In this study, patients in the experimental group applied 0.5 mg of estriol vaginal cream nightly for two weeks followed by twice-weekly applications for eight months.
References
- ↑ National Library of Medicine. Cystitis. Retrieved on 2007-11-13.
- ↑ McIsaac WJ, Moineddin R, Ross S (2007). "Validation of a decision aid to assist physicians in reducing unnecessary antibiotic drug use for acute cystitis". Arch. Intern. Med. 167 (20): 2201–6. DOI:10.1001/archinte.167.20.2201. PMID 17998492. Research Blogging.
- ↑ Gupta K, Hooton TM, Roberts PL, Stamm WE (2007). "Short-course nitrofurantoin for the treatment of acute uncomplicated cystitis in women". Arch. Intern. Med. 167 (20): 2207–12. DOI:10.1001/archinte.167.20.2207. PMID 17998493. Research Blogging.
- ↑ Meyhoff H, Nordling J, Gammelgaard P, Vejlsgaard R (1981). "Does antibacterial ointment applied to urethral meatus in women prevent recurrent cystitis?". Scand J Urol Nephrol 15 (2): 81-3. PMID 7036332.
- ↑ Jepson R, Mihaljevic L, Craig J. "Cranberries for preventing urinary tract infections.". Cochrane Database Syst Rev: CD001321. PMID 14973968.
- ↑ Raz R, Stamm W (1993). "A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections.". N Engl J Med 329 (11): 753-6. PMID 8350884.