Short-course Therapy of Acute Cystitis: A Brief Review of Therapeutic Strategies

J Antimicrob Chemother. 1999 Mar;43 Suppl A:85-93.

Abstract

Acute cystitis is one of the commonest medical problems encountered by primary care physicians. It affects more women than men (8:1), but the incidence among men is increasing. Uncomplicated cystitis by definition occurs in healthy patients with a normal urinary tract, whereas complicated cystitis implies a predisposing or underlying condition. A narrow range of aetiological agents is responsible for most uncomplicated cystitis in women (Escherichia coli in 80% of cases). Recently, however, pathogens usually associated with sexually transmitted disease have been implicated. In women with typical symptoms of acute uncomplicated cystitis, an abbreviated laboratory work-up followed by empirical therapy is recommended. Single-dose and 3 day regimens of co-trimoxazole and the quinolones are as effective as longer regimens and have a higher eradication rate than other commonly used antimicrobials. Relapse rates are slightly higher with single-dose therapy. With this success rate plus the reduced cost and improved patient compliance, these regimens have replaced traditional 5 to 14 day courses of treatment. With increasing resistance of the common urinary pathogens to amoxycillin and, now, co-trimoxazole, the quinolones are a logical choice for empirical therapy of uncomplicated urinary tract infections.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anti-Infective Agents / therapeutic use*
  • Cystitis / diagnosis
  • Cystitis / drug therapy*
  • Cystitis / etiology
  • Cystitis / microbiology
  • Enterobacteriaceae Infections / diagnosis
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / etiology
  • Enterobacteriaceae Infections / microbiology
  • Female
  • Fluoroquinolones
  • Humans
  • Male
  • Randomized Controlled Trials as Topic

Substances

  • Anti-Infective Agents
  • Fluoroquinolones