Treatment of 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 – 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 . 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 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 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 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 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 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 have become resistant to certain and no longer respond to them. The choice of will also depend on how common those 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 .

Many women drink a lot of water or tea to try to flush the 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 about the effectiveness of herbal, homeopathic or cranberry products.

Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM). Brennen beim Wasserlassen. S3-Leitlinie und Anwenderversion der S3-Leitlinie Harnwegsinfektionen. AWMF-Registernr.: 053-001. July 2018. (DEGAM guideline no. 1).

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.

Jepson RG, Mihaljevic L, Craig JC. Cranberries for treating urinary tract infections. Cochrane Database Syst Rev 2000; (2): CD001322.

Zalmanovici Trestioreanu A, Green H, Paul M, Yaphe J, Leibovici L. Antimicrobial agents for treating uncomplicated urinary tract infection in women. Cochrane Database Syst Rev 2010; (10): CD007182.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on October 24, 2019
Next planned update: 2022

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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