Treatment of acute, uncomplicated cystitis
DOI: 10.22591/magyurol.2025.3.szegedik.129
Authors:
Szegedi Krisztián dr.
Debreceni Egyetem, Klinikai Központ, Urológiai Klinika (igazgató: Flaskó Tibor)
Summary
Acute uncomplicated cystitis is a very common disease among women, which can be accompanied by severe symptoms. According to our knowledge, about half of the adult female population experiences symptoms typical of cystitis during their lifetime, and one third of women experience their first infection by the age of 24, so its proper treatment is of great importance in urological practice.
Since acute uncomplicated cystitis itself is a fundamentally rapid-acting, potentially non-serious disease, caution should be exercised when choosing treatment, and if possible, the patient should be informed about all options.
In recent years, a paradigm shift has occurred in the treatment of acute cystitis. The previous, early aggressive antibiotic treatment is increasingly being pushed into the background, taking into account the impact on the patient’s microbiome and environment, and non-antibiotic-based therapies are increasingly being emphasized in treatment, such as adequate fluid intake, non-steroidal anti-inflammatory drugs and phytotherapeutics.
If antibiotic treatment is still justified, the first-line antibiotic therapy (e.g. fosfomycin, nitrofurantoin) should be selected in accordance with professional guidelines, and the patient should be provided with lifestyle advice.
It is worth offering phytotherapeutics with so-called antiadhesive properties as an additional therapy. An excellent example of this is the combination of spiny needle (Ononis spinosa), Javanese tea leaf (Orthosiphon stamineus) and Canadian goldenrod (Solidago canadensis), with which we can most likely avoid the development of recurrent cystitis, reduce the intensity of complaints, the amount of antibiotics to be used and the duration of treatment. In addition, it is also psychologically more acceptable for patients, a kind of golden mean in the treatment of acute cystitis.