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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.<ref>{{Cite journal  |last1 = Hooton | first1 = TM. | title = Clinical practice. Uncomplicated urinary tract infection. | journal = N Engl J Med | volume = 366 | issue = 11 | pages = 1028-37 | month = Mar | year = 2012 |doi = 10.1056/NEJMcp1104429 | PMID = 22417256 }}</ref>
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.<ref>{{Cite journal  |last1 = Hooton | first1 = TM. | title = Clinical practice. Uncomplicated urinary tract infection. | journal = N Engl J Med | volume = 366 | issue = 11 | pages = 1028-37 | month = Mar | year = 2012 |doi = 10.1056/NEJMcp1104429 | PMID = 22417256 }}</ref>
===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''':<ref name="pmid21292654">{{cite journal| author=Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG et al.| title=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. | journal=Clin Infect Dis | year= 2011 | volume= 52 | issue= 5 | pages= e103-20 | pmid=21292654 | doi=10.1093/cid/ciq257 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21292654  }} </ref>
:*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==
==References==

Revision as of 19:39, 13 January 2017

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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.

Primary 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]

References

  1. ↑ 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)
  2. ↑ 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)

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