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Antibiotic treatments are very effective in treating bladder infections. A three day course of the antibiotics MacroBid or Trimethoprim is the standard treatment to cure the infection and reduce the risk of a recurrent bout.

To order cystitis treatment, fill in our brief questionnaire. Our online doctor will review your information and check whether an antibiotic course is the right treatment for you. This service is for women only.

Prescription and delivery are included.

  • Genuine medication from GMC registered doctors
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Medication Dosage Course Length Price
MacroBid® / Nitrofurantoin 100mg 3 days / 6 tablets £22
Trimethoprim 200mg 3 days / 6 tablets £18

What is Cystitis?

Cystitis is the name for an inflamed bladder. Normally, this is caused by a urine infection, but it can also be caused by damage or irritation, from having sex, for example. It is very common in women. Cystitis in men and children can be a sign of other underlying conditions, so for them, treatment should always be sought from a doctor.

How does cystitis treatment work?

Antibiotics help your body's immune system fight the infection. Trimethoprim and nitrofurantoin are antibiotics commonly used to treat cystitis. Whichever antibiotic your doctor prescribes, take the dose exactly as your doctor asked you to and be sure to complete the course, unless you are told to stop.

When should I consider cystitis treatment?

You should consider taking antibiotics for cystitis (also known as a water infection) when the problem doesn't improve after a couple of days and when self-care methods have failed. Most women who suffer from recurrent cystitis already know which treatment works best for them. The first line antibiotic treatment suitable for most cases of cystitis is either Trimethoprim or Nitrofurantoin (often sold as MacroBid).

Who needs which cystitis treatment?

Men and children who have cystitis should see a doctor to get treated. They should not be treated with over-the-counter remedies. Women who have cystitis for the first time should also see a doctor. The same goes for women who have recurrent bouts of cystitis, cystitis that does not clear up within a week or who are suffering from severe symptoms.

What are the symptoms of cystitis?

Cystitis is characterised by needing to urinate frequently and a stinging or burning pain when you urinate. You might have lower abdominal pain, pass blood in your urine or get a high temperature too. You might also notice, that your urine is cloudier than normal and smells bad. If you drink plenty of water, cystitis will sometimes go by itself in a few days, but you might need a short course of antibiotics to get rid of it completely. If you have an infection in your bladder and don’t treat it, it can cause the infection to spread to your kidneys.

How common is cystitis?

Women are eight times more likely than men to get cystitis (because a woman’s urethra is shorter and closer to the anus than a man’s). Up to 15% of women get cystitis each year, and 50 % of all women have cystitis at least once in their life.

When To Seek Treatment For A Bladder Infection

If your cystitis doesn't improve within a day or two (despite the use of home remedies), you should consult a doctor, so that he can prescribe you the right antibiotics – whichever type is best for you. Additionally, you should seek medical help if you experience the symptoms of severe – or acute – cystitis:

  • Fever and chills
  • Blood in the urine
  • Vomiting
  • Pain or discomfort in your lower back

People who have a history of kidney infections, heart problems or recurrent bladder infections should consult their doctor when suffering from cystitis.

This is also necessary for patients with diabetes, because bacteria thrive in sugar. There might be an increased risk that the infection spreads to the kidneys. Pregnant women who have a bladder infection also need close medical attention.

What can I do to avoid bladder infection?

Most urine infections are caused by germs from the bowel being transferred from your anus (back passage) to your urethra (the tube that your bladder sends urine through when you urinate). Certain types of bacteria thrive in urine and rapidly multiply, spreading the infection.

Most of the time, this happens when people don't go to the toilet often enough. This results in “left-overs” of urine and bacteria in the bladder that lead to an infection. So, remember to empty your bladder regularly and as completely as possible. This problem may also occur in people who don't drink enough. This can cause the urine to become more concentrated in the bladder, until it can be flushed out. This can also result in bacterial infections. It's possible that a blockage somewhere in your kidneys, bladder or urethra cause cystitis as well, for example because of kidney stones or prostate problems in men.

First Steps - Diagnosis of E.coli In Urine

Sometimes your GP might want to diagnose cystitis by detecting the presence of bacteria in your urine as well as asking you about your symptoms. In this case, your doctor will ask you for a sample of your urine, then examine it with a dip-stick or start a urine culture to identify which bacteria is the cause of your infection. This way they can prescribe the most suitable treatment to you. Since E.coli bacteria is the cause of most cases, your doctor may prescribe you trimethoprim or MacroBid to begin with. If other bacteria have caused the infection, or the E.coli are resistant to these antibiotics, your doctor will contact you to prescribe a more suitable treatment.

Which are the risk factors in Women?

It's estimated that 30-50% of women will have cystitis at some time in their life. Here's a list of all the risk factors that contribute:

  • Pregnancy – hormonal and physical changes can contribute to the infection;
  • Menopause – hormonal changes can contribute;
  • Using the contraceptive diaphragm;
  • Sexual activity (increase the chances of having bacteria pushed in the urethra) and having unprotected sex with new partners (infection due to the body's unfamiliarity to new bacteria carried by the new partner);
  • Diabetes – excess sugar facilitates the reproduction of bacteria;
  • Impaired immune system – i.e. when natural defenses are down (e.g. because of an illness or a cancer treatment).

Other risk factors of bladder irritation include:

  • Foreign bodies in or near the bladder (tubes, kidney stones,...);
  • Strong allergies to vaginal creams and other hygiene products;
  • Vaginal infections, such as thrush;
  • Sexually transmitted infections (STIs), such as chlamydia, can increase the risks of getting cystitis.

There is also some evidence that using a spermicide destroys the normal vaginal flora, including its bacteria, which can lead to an increase in the number of foreign bacteria which will then become the source of bladder infection.

Cystitis risk factors in men

Male bladder infection is usually a symptom of a more severe disease. It therefore requires a visit to the doctor. It is sometimes the sign of an obstruction somewhere within the urinary tract. STIs can also cause bladder infection in men.

Are there possible complications?

Most cases of cystitis pass within a few days. However, if they last for more than a few days, you should seriously consider a medical treatment for the bladder infection.There is a risk that cystitis could turn into a kidney infection, which is much more dangerous if left untreated.

After treatment, what should I expect?

Most women find that their cystitis improves within a few days of treatment. If your symptoms have not cleared or come back within two weeks, see your doctor. Some of the bacteria that can cause cystitis are resistant to different types of antibiotics. You may need to try a different course of treatment. 

Can I get treatment on the NHS?

Yes.

Cystitis in men

Cystitis occurs much less frequently in men. Sexually active gay men are more likely to get it than other men. Cystitis can be serious, because it can be a sign of:

  • An infection of the bladder or prostate (the gland between the penis and the bladder)
  • A blockage/obstruction in the urinary tract (e.g. from a tumour or an enlarged prostate)
  • Men who get cystitis should therefore see a doctor as soon as possible.

Which types of cystitis are there?

This page covers bacterial cystitis. However, there are other types of cystitis:

Interstitial cystitis – causes recurring discomfort in the bladder and pelvic area. It comes with a frequent and urgent need to urinate. The pain that it causes, along with other symptoms, vary from person to person. Women may find it even more painful when they are menstruating. Interstitial cystitis is normally diagnosed around age 40 and 90% of people who have it are women. It is treated with painkillers, bladder distension (increasing the bladders size by filling it), bladder instillation (filling the bladder with a solution to sooth irritation) or surgery.

Radiation cystitis – this is damage caused to the bladder by radiation therapy (such as when used to treat cancer in the pelvic organs). Symptoms include blood in the urine and pain. Treatments include painkillers, Hyaluronic Acid, Elmiron and Botox injections.

Chemotherapy Induced cystitis – caused by immunotherapy given directly to the bladder. Treatments include Hyaluronic Acid and Elmiron.
Cystitis Glandularis/Cystitis Cystica – In cystitis cystica, the lining of the bladder comes out in tiny blisters, in cystitis glandularis the lining is thicker over the blisters, giving a cobblestone appearance. Both are usually the result of a chronic urine infection. Treatment is usually long term antibiotics.

Which cystitis treatment options are there?

There are different approaches to treat cystitis. These vary from self help to antibiotics.The first option is not taking any medication. Often your immune system will clear the infection by itself. Cystitis often goes away without treatment within a few days, but if you don’t take antibiotics, it can last for up to about a week.

The second option is a short course of antibiotics. If you need this, your doctor will probably suggest a course of 3-5 days of antibiotics. Trimethoprim and nitrofurantoin are the antibiotics used most often to treat cystitis. You ought to see an improvement about a day after you start taking the medication. It is thought that taking antibiotics reduces the length of symptoms by about a day. You can ask your doctor to give you a prescription for antibiotics as a standby, to take if your symptoms get worse or don’t improve.

I am pregnant - what do I need to do?

If you’re pregnant and experiencing symptoms of cystitis, please see your doctor. Your doctor will help you find a treatment which won’t cause any harm to your baby.

Which antibiotics are used to treat cystitis?

Trimethoprim and nitrofurantoin are antibiotics that are commonly used to treat cystitis. Whichever antibiotic your doctor prescribes, take the doses exactly as your doctor asked you to and be sure to complete the course, unless you are told to stop.

Which side-effects can antibiotics have?

The most common side effects of trimethoprim are feeling or being sick, itching or a skin rash.

The most common side effects of nitrofurantoin are feeling or being sick, feeling dizzy and having diarrhoea. Nitrofurantoin might darken the colour of your urine, but this is normal and not anything to worry about.

Do they interact with other medication?

Tell your doctor, before taking these medications, if you:

  • are pregnant, breastfeeding or trying for a baby
  • think you might have glandular fever
  • have problems with your liver or kidneys or your breathing
  • are diabetic
  • are anaemic or have low levels of vitamin b or folic acid
  • have peripheral neuropathy
  • have porphyria or glucose 6-phosphate dehydrogenase (G6PD) deficiency
  • are taking other medicines
  • have ever been allergic to a medicine
  • if you are taking a contraceptive pill (you may need to use additional methods of contraception)

Always read the patient information leaflet for full details.

Drug name

Trimethoprim

Amoxicillin

Nitrofurantoin

Type of medicine

Antibiotic

Penicillin antibiotic

Antibiotic

How long it takes to work

You ought to see an improvement after the first couple of days of taking any of these antibiotics. Be sure to complete the course, even if your symptoms go away[b].

same as Trimethoprim

same as Trimethoprim

Risks

Tell your doctor, before taking these medications, if you:

  • are pregnant, breastfeeding or trying for a baby
  • think you might have glandular fever
  • have problems with your liver or kidneys or your breathing
  • are diabetic
  • are anaemic or have low levels of vitamin b or folic acid
  • have peripheral neuropathy
  • have porphyria or glucose 6-phosphate dehydrogenase (G6PD) deficiency
  • are taking other medicines
  • have ever been allergic to a medicine.

If you are allergic to penicillin do not take this medicine.

Tell your doctor, before taking these medications, if you:

  • are pregnant, breastfeeding or trying for a baby
  • think you might have glandular fever
  • have problems with your liver or kidneys or your breathing
  • are diabetic
  • are anaemic or have low levels of vitamin b or folic acid
  • have peripheral neuropathy
  • have porphyria or glucose 6-phosphate dehydrogenase (G6PD) deficiency
  • are taking other medicines
  • have ever been allergic to a medicine.

Tell your doctor, before taking these medications, if you:

  • are pregnant, breastfeeding or trying for a baby
  • think you might have glandular fever
  • have problems with your liver or kidneys or your breathing
  • are diabetic
  • are anaemic or have low levels of vitamin b or folic acid
  • have peripheral neuropathy
  • have porphyria or glucose 6-phosphate dehydrogenase (G6PD) deficiency
  • are taking other medicines
  • have ever been allergic to a medicine.

Side effects

Feeling or being sick, itching or a skin rash

Feeling or being sick, having diarrhoea or a skin rash

Feeling or being sick, feeling dizzy, having diarrhoea

If you have a question about this service, please email info@dred.com with the question, and one of our doctors will get back to you within 24 hours.

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