Treating Uncomplicated Cystitis

Kiran Panesar, BPharmS (Hons), MRPharmS, RPh, CPh

US Pharmacist. 2013;38(8):34-37.

Conclusion

Despite the range of antimicrobials available to manage UTIs, their incidence and recurrence rates still remain high. Effective management is further complicated by the fact that the causative uropathogenic organisms continue to develop resistance to antimicrobials. Pharmacists play an important role in counseling patients on the correct use of their prescribed medications and discussing various strategies to prevent recurrence of cystitis.

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Table 1. Phenazopyridine Preparations Available in the U.S.
Product	Formulation^a
Azo Standard	95 mg
Azo Standard Maximum Strength	97.5 mg
Uricalm	99.5 mg
Uristat	95 mg

^aPhenazopyridine content per tablet. Source: Reference 13.

Table 2. Dosages of Antibiotics Used in Managing Uncomplicated Cystitis
Drug	Dosage
TMP-SMX	160/800 mg po bid for 3 days
Fluoroquinolones	Ciprofloxacin 250 mg po bid for 3 days or Levofloxacin 250–500 mg po qd for 3 days or Ofloxacin 300 mg po bid for 7 days
Nitrofurantoin monohydrate macrocrystals	100 mg po bid for 5 days with meals
Fosfomycin	3 g sachet in a single dose

TMP-SMX: trimethoprim-sulfamethoxazole. Source: References 2, 15.

Table 3. Behavioral Strategies to Reduce Recurrent Cystitis
Abstain from or reduce the frequency of sexual intercourse, if possible, as this is the strongest risk factor for UTIs Avoid spermicides and condoms with spermicides, which alter the vaginal flora Urinate as soon as possible after intercourse and drink plenty of fluids Do not delay urination Wipe front to back after defecation Avoid tight-fitting underwear Avoid douching

UTI: urinary tract infection. Source: References 2, 13.

Table 4. Antimicrobial Therapy to Prevent Cystitis
Drug	Single Dose^a	Continuous Antimicrobial Prophylaxis^b
Nitrofurantoin	50–100 mg	50–100 mg
TMP-SMX	40/200 mg or 80/400 mg	40/200 mg
TMP	100 mg	100 mg
Cephalexin	250 mg	125–250 mg
Fosfomycin	—	3 g sachet every 10 days