Cystitis

How Is Cystitis Treated?

Cystitis is almost always treated with medication.

These medications include:

• Oral antibiotics
• Painkillers
• Antispasmodics

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.

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.

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)