Acute cystitis

Most common aetiological organisms are Escherichia coli (79%), Staphylococcus saprophyticus (4%), Klebsiella pneumoniae (4%), and Proteus mirabilis (4%), followed by other bacteria (9%).

For uncomplicated acute cystitis, first-line treatment is 3 days of trimethoprim/sulfamethoxazole or trimethoprim, or 5 days of nitrofurantoin.

For complicated cases of cystitis, first line is empirical therapy with a fluoroquinolone antibiotic for 7 to 14 days; treatment should be adjusted based on the results of the urine culture.

Complicating characteristics include pregnancy; recent instrumentation, including catheterisation or indwelling catheter; male patient; diabetes, immunosuppression; structurally or functionally abnormal urinary bladder; history of recurrent urinary tract infections; history of infection with drug-resistant bacteria; or failed course of treatment for uncomplicated cystitis.

Acute cystitis is an infection of the urinary bladder most commonly affecting young, sexually active women. It can be classified as complicated or uncomplicated based on the presence of patient characteristics that would indicate a probable poor response to a short course of therapy.[1]European Association of Urology. Guidelines on urological infections. 2020 [internet publication]. https://uroweb.org/guideline/urological-infections/