Acute Cystitis

Management of acute cystitis involves the following:

Acute uncomplicated cystitis

In young female non-pregnant patients in areas with low E.coli resistance, trimethoprim is still a reliable empiric treatment. Nitrofurantoin must not be used if pyelonephritis is suspected, as it has poor efficacy in the upper urinary tract. Cephalexin is also an option. Some clinicians discourage the use of ciprofloxacin for uncomplicated cystitis in an attempt to reduce further resistance and have implicated it in the development of C.difficile [3].

Acute complicated cystitis

In cases of acute complicated cystitis, avoid trimethoprim. Instead, ciprofloxacin or cephalexin may be used. Take account of local antimicrobial resistance data and follow NICE guidance and/or local guidance when prescribing antibiotics. [11,12]