Cystitis

Cystitis information, advice, and order treatment online - be prepared with standby antibiotic.

Read medical information and answer medical questions to buy treatment online.

Medical information

Cystitis

Repeated cystitis, also known as water infections or urinary tract infections (UTI), can be uncomfortable and troublesome. Some women are prone to repeated episodes of cystitis. Men rarely suffer from cystitis, but when they do it tends to be more serious. The treatment offered here is NOT for men, only for women who are prone to repeated uncomplicated water infections.

Antibiotics for cystitis from Dr Fox service

Dr Fox supplies only standby antibiotics, either trimethoprim or nitrofurantoin, to keep in reserve to take if an infection develops. Standby antibiotic treatment is only for those women who are prone to cystitis and have already been diagnosed with it in the past. You should only use this treatment if you are confident you recognise the symptoms when you get them.

How to choose whether to order trimethoprim or nitrofurantoin is discussed below. A short questionnaire must be completed after choosing the required antibiotic. This ensures the treatment is correct for you and that you are aware of how to use it.

This postal service is not for the treatment of cystitis that has already started. If cystitis symptoms have already started consult your surgery or out-of-hours service. This will guarantee there is no delay in starting treatment.

Patients ordering antibiotics from us are required to provide their GP details. We will inform your surgery each time treatment is supplied. This allows GPs to monitor overall treatment.

Simple uncomplicated cystitis

Simple cystitis is the term used to describe an infection in the urine which is causing mild to moderate symptoms, where the infection has not spread to the kidneys, and is not causing severe generalised symptoms. Self-treatment with standby antibiotics is usually effective for simple cystitis. Symptoms usually improve within 24 hours. Symptoms of simple cystitis include:

  • Burning and soreness when passing water (doctors call this dysuria)
  • A need to pass water frequently, sometimes many times in an hour
  • A need to run to the toilet quickly and and not being able to hold urine for longer periods
  • The urine may be brown or murky and may smell strong
  • People with cystitis often feel uncomfortable and unwell, and are sometimes slightly feverish

Severe or complicated cystitis

Women who have severe urine infections, a past history or serious urinary infection, or worsening symptoms once they have started treatment, should consult their regular doctor straight away. They should not self-treat, even with antibiotics, unless they are under the supervision of their regular doctor. This also applies to women who are pregnant, or have kidney or bladder abnormalities, stones, or reduced kidney function.

Severe symptoms arise when infection moves up from the bladder to the kidneys or when infection affects the whole body. Infection of the kidneys is known as pyelonephritis and requires urgent medical attention and sometimes hospital treatment.

Any of the following symptoms may indicate serious pyelonephritis or other serious infection:

  • Back pain (indication of possible infection in the kidney)
  • Fever (high temperature, flushing, shivering, feeling hot and cold)
  • Nausea and sickness and loss of appetite
  • Generalised aching and flu-like feeling and confusion

All the above symptoms suggest something more serious than a simple cystitis and the need to seek medical advice straight away.

Prevention and self-treatment without antibiotics

Sometime the frequency of episodes of cystitis infections can be reduced by wearing natural fibre rather than synthetics next to the skin. Drinking plenty each day also helps to keep the bladder flushed and can help to reduce infections. Passing water after intercourse can help for women who tend to get infections after intercourse. These simple measures may be helpful in preventing infection, although often they are not.

Sometimes cystitis will go by itself in a few days, without antibiotic treatment. It helps to drink plenty (2-3 litres or 4-5 pints a day) and over the counter preparations from pharmacies, such as cranberry tablets but not juice, which change the acidity of the urine can also be useful. If symptoms are mild, self-treatment and wait-and-see for a few days may be the best approach. If symptoms are severe or worsening antibiotics are usually preferred. Women who have repeated infections will usually know if their symptoms are likely to stop on their own.

Recurring infection

Doctors often cannot find out why a woman is getting repeated episodes of cystitis. When a woman first starts having these infections tests are sometimes carried out. These tests are usually normal.

In some women cystitis is associated with recent intercourse or can be associated with stress. However, most water infections seem to start for no particular reason. If a woman has repeated episodes of cystitis, and the pattern of infection and symptoms are not changing, doctors usually just treat with antibiotics as each infection arises.

Choosing between trimethoprim or nitrofurantoin

Trimethoprim and nitrofurantoin are both antibiotics. They are usually both effective in treating cystitis, although there is increasing antibiotic resistance to trimethoprim. Nitrofurantoin is now (2017) the most widely prescribed first line treatment for cystitis. A first-line treatment is the one that is usually recommended and prescribed first by doctors. Up to 30% of bacteria which cause water infections are currently resistant to trimethoprim. The amount of bacterial resistance to particular antibiotics varies from one part of the country to another.

Women who get repeated water infections may well already know which antibiotic tends to be best for them. They may find that either nitrofurantoin or trimethoprim is not suitable for them, or has side-effects. Nitrofurantoin is a good first choice, because in general there is less bacterial resistance, but many infections respond well to trimethoprim. Women who have been taken trimethoprim within the previous year should consider taking nitrofurantoin. Your GP should be able to advise if you are not sure which antibiotic to obtain. Remember, if you already have an infection contact your surgery or out-of-hours service.

For more information about each antibiotic see the nitrofurantoin page and the trimethoprim page. There are also links below to the manufacturer's leaflets supplied with these medicines. Antibiotic for cystitis is taken once every 12 hours for 3 days.

Other antibiotics commonly used to treat cystitis include ciprofloxacin, norfloxacin, ofloxacin, and co-amoxiclav (Augmentin). These antibiotics tend to be reserved for more serious infections or special situations and are not available from Dr Fox.

Response to treatment

Simple cystitis will improve greatly within 24 hours of starting antibiotics. If symptoms are not improving in the first 24 hours, or have not gone completely at the end of 3 days, medical advice is needed. A urine sample may need to be sent for laboratory testing. If symptoms worsen rather than improve medical advice is needed straightaway.


Antibiotic guardianship

Antibiotic Guardian logo

To combat antibiotic resistance please:

  • Only use antibiotics when needed
  • Never share antibiotics
  • Always complete course as instructed
  • Take unused medicine to local pharmacy for disposal

Buy treatment

Dr Fox supplies treatment on prescription – you are required to answer a short medical questionnaire before your order can be completed.


Authored 18 February 2010
by Dr Tony Steele

Reviewed 12 December 2017 by Dr B. Babor, Dr A. Wood, Dr P. Hunt

Last updated 20 September 2018


Treatment available

Prices
Nitrofurantoin

Nitrofurantoin 100mg

6 caps (1 course) £12.50

Buy treatment
Trimethoprim

Trimethoprim 200mg

6 tablets (1 course) £9.50

Buy treatment

Prices

Cystitis treatmentQuantityCost
Nitrofurantoin 100mg6 capsules (1 course of treatment)£12.50
Trimethoprim 200mg6 tablets (1 course of treatment)£9.50

Prescription issued online - small prescription fee per order.

Compare prices: Dr Fox prices are 25%-50% lower cost than other online clinics.

Prescription fees

Dr Fox supplies medicine on prescription and charges a small prescription fee based on the order value of each prescription.

Prescriptions are issued by our doctors online and sent electronically to our pharmacy.

If you have your own private or NHS paper prescription please post to our pharmacy (details).

Dr Fox prices are 25%–50% lower than other UK online clinics.

Order valuePrescription fee
up to £10£1.00
up to £20£2.00
up to £40£3.00
over £40£4.00
Comparative costs of cystitis antibiotic from UK online clinics (27 November 2017) - qualifying notes
*Dr Fox adds a small prescription fee not included in table above.
  1. The prices shown are listed by the online clinics named after a customer first enters consultation information and is offered prescriptions. It is possible these clinics may have special offers or lower prices for repeat supplies.
  2. Prices may change and are, to the best of our knowledge, accurate on the date stated. All products in stock and new condition.
  3. Dr Fox does NOT claim to provide a superior service to any of the online clinics listed. All the clinics listed, as far as we can tell, comply with all regulation and, as far as we can tell, operate to high ethical standards.
  4. Dr Fox adds a small prescription fee not included in the table (between £1 and £4 depending on value of the order).
  5. To amend the information in this table please contact us
  6. The prices listed in the table do not identify the cost of prescription medicine as online clinics charge a single fee to cover services which includes advice, consultations, prescriptions and dispensing and supply of treatments.
  7. Where services include free delivery this is using the slowest delivery option available. Dr Fox uses Royal Mail Tracked 24.
ItemsDr FoxPharmacy2USuperdrugExpress PharmacyLloydsMed Express
Nitrofurantoin 100mg x 6£12.50n/a£25.00n/a£23.99n/a
Trimethoprim 200mg x 6£9.50£15.00£23.00£19.99£19.99£19.99
UK delivery£2.90£3.45included£2.95included£2.90

Delivery charges

UK delivery only: £2.90 per consultation via Royal Mail 24 Signed For (1-3 working days with tracking).

Parcel forwarding services are not permitted. Use only UK home or work delivery address.

Returns and refunds - unwanted items can be returned within 14 working days for a full refund.

  1. Medical questions
  2. Choose treatment
  3. Complete order

Answer medical questions to order(cystitis)

Women only

Have you read the medical information?

See medical information
Please note, we provide treatment for women only NOT men.

Have you been diagnosed with cystitis in the past?

Are you aware Dr Fox supplies 'standby' treatment only for cystitis?

  • If you already have symptoms a postal service will take too long.
  • Women who have cystitis symptoms already should contact their GP.

Are you aware Dr Fox doctors may decline repeat orders made before 6 months?

If ordering earlier, please message the reason to our doctors from your account area after completing your order.

Do you wish to order Nitrofurantoin or Trimethoprim?

  • Only one or the other can be ordered on each consultation.
  • The medical information and pages about nitrofurantoin and trimethoprim will help you choose which you require.
  • Nitrofurantoin is the usual first choice, but does not suit everyone.

Are you planning to take nitrofurantoin or trimethoprim whilst pregnant or breastfeeding?

Are you aware the following symptoms would require urgent medical advice?

  • Back pain (symptom of possible kidney infection)
  • Flu like symptoms (fever, nausea and vomiting, rashes, and collapse)

Are you aware cystitis symptoms should improve within 24 hours and resolve within 3 days of starting antibiotics?

Symptoms not improving within 24 hours or not resolved within 3 days require further medical assessment.

Do you have any further relevant questions or medical information for the doctor?

Do all the following apply to you?


The order process

Answer short medical questionnaire

Choose treatment, register, and pay

Doctor issues prescription online

Medicine posted direct from pharmacy


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