Cystitis prevention

Urinary Tract Infections Main Page
Cystitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Cystitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
Echocardiography and Ultarsound
CT Scan
MRI
Other Imaging Findings
Other Diagnostic Tests
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Cystitis prevention On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Cystitis prevention All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Cystitis prevention
CDC on Cystitis prevention
Cystitis prevention in the news
Blogs on Cystitis prevention
Directions to Hospitals Treating Cystitis
Risk calculators and risk factors for Cystitis prevention

Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Steven C. Campbell, M.D., Ph.D. Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]

Prevention

Non-antimicrobial approach

• Though it is difficult to apply, but abstinence or reduce frequency of sexual intercourse (which is the strongest risk factor for UTI)is a good method to reduce the risk of infection.
• Increasing the intake of fluids may allow frequent urination to flush the bacteria from the bladder. Urinating immediately after sexual intercourse may help eliminate any bacteria that may have been introduced during intercourse. Refraining from urinating for long periods of time may allow bacteria time to multiply, so frequent urinating may reduce risk of cystitis in those who are prone to urinary tract infections.
• Using contraception methods other than spermicides especially with diaphragm or spermicide-coated condoms, because they alter normal vaginal flora allowing pathogens to colonize.
• Topical estrogen for postmenopausal women maintains normal vaginal flora and reduces risk of UTIs.
• Cranberry juice, capsules or tablets:although it inhibits uropathogen from adherence to uroepithelial cells, but studies revealed no benefit from using cranberry juice.
• D-mannose theoretically inhibits E.Coli= adherence to oruepithelium, but no studies support the benefit or effectiveness..

Antimicrobials approach

• As treatment ,choosing the appropriate antimicrobial should depend on patient allergy and susceptibility of the causative organism.
• Self-diagnosis and self treatment: for women with previous infection that can self-diagnose a subsequent cystitis are advised to start first line regimen at the onset of urinary symptoms.85-95% accuracy of diagnosis with no clinic visit needed so it has better satisfaction.
• Antimicrobial prophylaxis

Postcoital regimen is used when coitus related UTI is suspected.

Postcoital prophylaxis Single dose ▸ Nitrofurantoin 50-100 mg PO ▸TMP-SMX 40/200 mg or 80/400 mg PO. ▸TMP 100 mg PO. ▸Cephalexin 250 mg PO.

• Urine culture should be done to confirm absence of bacteriuria.

Continuous prophylaxis Bed time daily dose except Fosfomycin ▸ Nitrofurantoin 50-100 mg PO. ▸TMP-SMX 40/200 mg PO. ▸TMP 100 mg PO. ▸Cephalexin 250 mg PO. ▸Fosfomycin 3 g every 10 days.