Treating acute cystitis

Photo of a packet of tablets (PantherMedia / Lasse Kristensen)

Antibiotics can quickly relieve the symptoms of acute cystitis and get rid of the infection. There are various household remedies and herbal products too. But these haven’t yet been scientifically proven to work.

Uncomplicated cystitis is very common. It is caused by a bacterial infection. The main symptom is a burning pain when urinating, often accompanied by an increased urge to urinate. Although these symptoms are very unpleasant, they can be treated effectively. Uncomplicated cystitis usually goes away without any problems.

Women have different ways of coping with cystitis. Some wait for a couple of days to see if the symptoms go away on their own, or they may follow common advice such as drinking plenty of fluids or going to the toilet after sexual intercourse. Many others decide to take antibiotics because of the unpleasant symptoms.

Antibiotics provide quick relief

Antibiotics have been shown to provide quick and effective relief for uncomplicated cystitis. The pain and burning usually subside within one to three days and then go away completely soon after.

The length of treatment depends on the specific antibiotic. Nowadays, most antibiotics either need to be taken for three days or for more than five days. In the past it was quite common for doctors to prescribe single-dose antibiotic treatment. Although that was usually enough to relieve the symptoms, surviving bacteria often caused the cystitis to come back.

In most women, a three-day treatment is enough to reduce the symptoms. Taking antibiotics for longer doesn’t improve symptom relief. But it is more likely to cause side effects such as vaginal thrush, stomach and bowel problems, and rashes. Shorter courses of antibiotics may allow more bacteria to survive in the bladder, though. It isn’t clear whether cystitis comes back again (recurs) more often as a result.

So the choice of antibiotics needs to be considered on an individual basis: Women who want to be as sure as possible that the infection is completely gone might choose antibiotics that are taken for five or more days. Women who want to minimize the risk of side effects might prefer antibiotics that only need to be taken for three days.

You can talk to your doctor about which antibiotic would be suitable for you. Whichever medication you choose, it is important to take it as prescribed, and not to stop early.

Research summaries

What else can I do if I have cystitis?

Many women try to "flush” the bacteria out of their bladder by drinking a lot of water or tea. Heat (e.g. from a hot water bottle, electric blanket or warm bath) is sometimes applied too, to try to relieve pain and relax. But there is no research on how effective these home remedies are.

Some women also try out a number of different herbal remedies to treat cystitis, including the following:

  • Diuretic herbal products like birch leaf, horsetail or stinging nettles
  • Products containing bearberry leaves, cranberries or bilberries

None of these remedies have been scientifically proven to help, though. The same is true for homeopathic products and procedures used in traditional Chinese medicine. Some might even do harm when used over longer periods of time.

Women who have recurrent cystitis are sometimes offered bladder irrigations to prevent bacteria from sticking to the bladder. There isn’t enough research to be able to say whether flushing out the bladder like this helps. German statutory health insurers do not cover the costs of this treatment.

In acute cystitis, painkillers can reduce the burning pain when passing urine. You will find more information about the possible side effects of the painkiller on the package insert. If you aren’t sure whether it makes sense to take a painkiller, or which one is suitable, you can consult your doctor.