Treatment of acute cystitis
Antibiotics can quickly relieve the symptoms of acute cystitis and get rid of the infection – but they aren't always needed in milder cases. Household remedies and herbal products are also available. These haven’t yet been scientifically proven to work, though.
Uncomplicated cystitis is very common. It is caused by a bacterial infection. The main symptom is burning pain when peeing (urinating). There is also usually an increased urge to urinate. These symptoms are very unpleasant, but they can be treated effectively. Uncomplicated cystitis normally goes away without any trouble.
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. But many others decide to take antibiotics because of the unpleasant symptoms.
How effective are antibiotics?
Antibiotics have been shown to be fast and effective in treating uncomplicated cystitis. The pain and burning usually get better within one to three days and then go away completely a short time later. But sometimes antibiotics aren't needed at all. If the symptoms are bearable and no complications are expected, they aren't necessary.
How long you need to take the antibiotics depends on the specific drug: usually 1, 3, 5 or 7 days, or longer in rare cases. One to three days of treatment is usually enough to relieve the symptoms in most women. Taking antibiotics for longer doesn't improve symptom relief. But it is more likely to cause side effects such as vaginal yeast infections, stomach and bowel problems, and skin rashes.
You can talk to your doctor about which antibiotics can be used in your case. That will depend on any other medical conditions you have and whether you have a higher risk of complications. Some bacteria have become resistant to certain antibiotics and no longer respond to them. The choice of antibiotics will also depend on how common those bacteria are. Whichever medication you choose, it is important to take it as described in the package insert, and not to stop the treatment early.
What else can I do if I have cystitis?
If you have acute cystitis, painkillers like acetaminophen (paracetamol) or ibuprofen can reduce the burning pain when peeing. If that already helps to improve mild or moderate symptoms, you don't need to take antibiotics.
Many women drink a lot of water or tea to try to flush the bacteria out of their bladder. Home remedies like applying heat (e.g. with a hot water bottle, electric blanket or warm bath) are also used to try to relieve pain and to relax. But there's no research on how effective these home remedies are.
There's also no evidence about the effectiveness of herbal, homeopathic or cranberry products.
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Deutsche Gesellschaft für Urologie (DGU). Interdisziplinäre S3 Leitlinie: Epidemiologie, Diagnostik, Therapie, Prävention und Management unkomplizierter, bakterieller, ambulant erworbener Harnwegsinfektionen bei erwachsenen Patienten. Update 2017. AWMF-Registernr.: 043-044. April 2017.
Falagas ME, Kotsantis IK, Vouloumanou EK, Rafailidis PI. Antibiotics versus placebo in the treatment of women with uncomplicated cystitis: a meta-analysis of randomized controlled trials. J Infect 2009; 58(2): 91-102.
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