Cystitis prevention: Difference between revisions
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{{Cystitis}} | {{Cystitis}} | ||
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==Overview== | ==Overview== | ||
Preventative measures to avoid cystitis include abstinence from sexual activity, use of barrier contraception during sexual intercourse, increasing fluid intake and frequency of urination, and use of estrogen (among post-menopausal women). Single-dose prophylactic antimicrobial therapy prior to sexual intercourse may be administered to patients who have recurrent episodes of cystitis that are associated with sexual activity. | Preventative measures to avoid cystitis include abstinence from sexual activity, use of barrier contraception during sexual intercourse, increasing fluid intake and frequency of urination, and use of estrogen (among post-menopausal women). Single-dose prophylactic antimicrobial therapy prior to sexual intercourse may be administered to patients who have recurrent episodes of cystitis that are associated with sexual activity. | ||
Revision as of 20:32, 24 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.
Overview
Preventative measures to avoid cystitis include abstinence from sexual activity, use of barrier contraception during sexual intercourse, increasing fluid intake and frequency of urination, and use of estrogen (among post-menopausal women). Single-dose prophylactic antimicrobial therapy prior to sexual intercourse may be administered to patients who have recurrent episodes of cystitis that are associated with sexual activity.
Prevention
Non-antimicrobial Approach
The following preventative measures may reduce the risk of cystitis: [1]
- Abstinence from sexual activity
- Barrier contraception during sexual intercourse
- Increasing the intake of fluids and the frequency of urination
- Use of topical estrogen among post-menopausal women
The use of cranberry to prevent cystitis remains controversial. Cranberry is thought to prevent the adherence of uropathogens to urothelial cells, but its benefit is yet to be proven.[2]
Antimicrobial Prophylaxis
- Prophylactic therapy using antimicrobial agents may be considered among women with recurrent episodes of cystitis that are associated with sexual activity.
- The following regimens may be used as single doses prior to sexual activity.
- Prophylactic Therapy:[3]
- Preferred regimen (1): Fosfomycin tromethamine 3 g PO in a single dose
- Preferred regimen (2): Nitrofurantoin monohydrate/macrocrystals 100 mg PO in a single dose
- Preferred regimen (3): Trimethoprim-Sulfamethoxazole 160/800 mg PO double-strength tablet bid in a single dose
- Preferred regimen (4): Trimethoprim 100 mg PO bid in a single dose
- Alternative regimen (1): Ciprofloxacin 250 mg PO bid in a single dose
- Alternative regimen (2): Levofloxacin 250 mg PO qd in a single dose
- Alternative regimen (3): Norfloxacin 400 mg PO bid in a single dose
- Alternative regimen (4): Gatifloxacin 200 mg PO qd in a single dose
References
- ↑ Raz, R.; Stamm, WE. (1993). "A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections". N Engl J Med. 329 (11): 753–6. doi:10.1056/NEJM199309093291102. PMID 8350884. Unknown parameter
|month=ignored (help) - ↑ Hooton, TM. (2012). "Clinical practice. Uncomplicated urinary tract infection". N Engl J Med. 366 (11): 1028–37. doi:10.1056/NEJMcp1104429. PMID 22417256. Unknown parameter
|month=ignored (help) - ↑ Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG; et al. (2011). "International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases". Clin Infect Dis. 52 (5): e103–20. doi:10.1093/cid/ciq257. PMID 21292654.