Cystitis secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D., Usama Talib, BSc, MD [2]
Overview
Secondary prophylaxis of cystitis is useful to prevent recurrent cystitis. It is more beneficial in patients in which cystitis is associated with sexual intercourse, a structural defect or a disease like diabetes that can lead to recurrent infections.
Secondary Prevention
The secondary prevention of cystitis includes the prophylaxis to prevent recurrent cystitis.
Antimicrobial Prophylaxis
- Prophylaxis is required in individuals having two or more episodes in 6 months or three or more episodes in 12 months period.[1][2]
- Prophylactic therapy using antimicrobial agents may be considered as either continuously or postcoital prophylaxis for 6 to 12 months.
- The following regimens may be used as single doses prior to sexual activity.[3]
- Prophylactic Therapy:
- 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
- Post-Coital Ciprofloxacin has been found to be similar in effect to daily Ciprofloxacin.[4]
- Nitrofurantoin and Fosfomycin effective for use as long term prophylaxis.[5][6]
References
- ↑ Nicolle LE, Ronald AR (1987). "Recurrent urinary tract infection in adult women: diagnosis and treatment". Infect Dis Clin North Am. 1 (4): 793–806. PMID 3333659.
- ↑ Ronald AR, Conway B (1988). "An approach to urinary tract infections in ambulatory women". Curr Clin Top Infect Dis. 9: 76–125. PMID 3077293.
- ↑ 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.
- ↑ Melekos MD, Asbach HW, Gerharz E, Zarakovitis IE, Weingaertner K, Naber KG (1997). "Post-intercourse versus daily ciprofloxacin prophylaxis for recurrent urinary tract infections in premenopausal women". J Urol. 157 (3): 935–9. PMID 9072603.
- ↑ Brumfitt W, Hamilton-Miller JM (1998). "Efficacy and safety profile of long-term nitrofurantoin in urinary infections: 18 years' experience". J Antimicrob Chemother. 42 (3): 363–71. PMID 9786476.
- ↑ Rudenko N, Dorofeyev A (2005). "Prevention of recurrent lower urinary tract infections by long-term administration of fosfomycin trometamol. Double blind, randomized, parallel group, placebo controlled study". Arzneimittelforschung. 55 (7): 420–7. doi:10.1055/s-0031-1296881. PMID 16080282.