A study from Northwestern Medical School showed that many women with recurrent bladder infections should be given antibiotics to keep at home and treat themselves when they have symptoms (1).
When men have burning on urination, they usually have a venereal disease. When women have the same symptom, they usually have a bladder infection. Burning on urination can be caused by either a bladder or a vaginal infection. Two studies showed that If bacteria grow from your urine culture, you could be cured 90 percent of the time with one 500 mg ciprofloxacin pill (1) and a seven day course of 500 mg twice a day cures 98 percent (2). However, all quinolone antibiotics can have terrible side effects, so current recommendations are not to use these antibiotics until other safer antibiotics fail to cure an infection.
More than 75 percent of all recurrent bladder infections are caused by a single germ called E. Coli (3). Women with recurrent E. Coli bladder infections usually suffer a genetic susceptibility in which the bacteria that is found normally in everyone's intestines climbs from the skin into the bladder (4). If you have E. Coli, your doctor may prescribe a supply of ampicillin or sulfa drugs, and tell you to take one pill before lovemaking or for three days when you have symptoms. Surgical procedures to widen the opening to the bladder are usually ineffective. (5)
If your urine culture does not grow any bacteria, the odds are that you have a mycoplasma or chlamydia infection that can be cured when you and your partner take doxyxline or long-acting erythromycins such as Biaxin or Zithromax. If you still have symptoms, you will need a more thorough evaluation from your doctor.
More on E. Coli syndrome
1) AJ Schaeffer, BA Stuppy. Efficacy and safety of self-start therapy in women with recurrent urinary tract infections. Journal of Urology 161: 1 (JAN 1999):207-211.
2) Guibert J. Acute cystitis in women: Effectiveness of ciprofloxacin versus pefloxacin given as a single oral dose. Presse Med 1995 FEB 11;24(6):304-308. 92% clinical cure for ciprofloxacin. Mean time to clinical resolution was about 40 hours.
3) A Iravani, AD Tice, J Mccarty, DH Sikes, T Nolen, HA Gallis, EP Whalen, RL Tosiello, A Heyd, SF Kowalsky, RM Echols. Short-course ciproflox treatment of acute uncomplicated urinary tract infection in women: The minimum effective dose. Archives of Internal Medicine 155: 5 (MAR 13 1995):485-494. Bacteriologic eradication was reported in 95 (89%) and 101 (98%) of patients in the groups who received ciprofloxacin, 500-mg single dose and 250 mg BID for 7 days, respectively.
4) R Ikaheimo, A Siitonen, T Heiskanen, U Karkkainen, P Kuosmanen, P Lipponen, PH Makela. Recurrence of urinary tract infection in a primary care setting: Analysis of a 1-year follow-up of 179 women. Clinical Infectious Diseases 22: 1 (JAN 1996):91-99.
5) Hooks on the bacteria E. Coli. Nature January 12, 1995.
6) Dilatation is ineffective. British Journal of Urology November, 1992.
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