Antibiotic treatments are very effective in treating bladder infections. A three day course of the antibiotic MacroBid (nitrofurantoin) is the standard treatment to cure the infection and reduce the risk of a recurrent bout.
To order cystitis treatment, fill in our brief questionnaire. Our online doctor will review your information and check whether an antibiotic course is the right treatment for you. This service is for women only.
Prescription and delivery are included.
How quickly does it work
Within 2 - 3 days of taking the antibiotic.
Who can take it
Nitrofurantoin may not be suitable for you if you are pregnant, breastfeeding or trying for a baby, think you might have glandular fever, have problems with your liver or kidneys or your breathing, are diabetic, are anaemic or have low levels of vitamin b or folic acid, have peripheral neuropathy, have porphyria or glucose 6-phosphate dehydrogenase (G6PD) deficiency, are taking other medicines or have ever been allergic to a medicine.
Feeling or being sick, feeling dizzy, having diarrhoea.
This used to be a recommended treatment for cystitis but due to increased antibiotic resistance, it’s no longer suitable in the UK. Instead, the recommended antibiotic treatment is MacroBid (nitrofurantoin) which you can order for your cystitis online from Zava.
Cystitis is the name for an inflamed bladder. Normally, this is caused by a urine infection, but it can also be caused by damage or irritation, from having sex, for example. It is very common in women. Cystitis in men and children can be a sign of other underlying conditions, so for them, treatment should always be sought from a doctor.
Symptoms of cystitis include:
- needing to urinate frequently and a stinging or burning pain when you urinate
- lower abdominal pain,
- pass blood in your urine
- a high temperature
- your urine is cloudier than normal and smells bad
If you drink plenty of water, cystitis will sometimes go by itself in a few days, but you might need a short course of antibiotics to get rid of it completely. If you have an infection in your bladder and don’t treat it, it can cause the infection to spread to your kidneys.
Antibiotics help your body's immune system fight the infection. Nitrofurantoin is an antibiotic commonly used to treat cystitis. If your doctor approves treatment, take the dose exactly as they ask you to and be sure to complete the course, unless you are told to stop.
You should consider taking antibiotics for cystitis (also known as a water infection) when the problem doesn't improve after a couple of days and when self-care methods have failed. Most women who suffer from chronic cystitis already know which treatment works best for them. The first line antibiotic treatment suitable for most cases of cystitis is Nitrofurantoin (often known as MacroBid).
Men and children who have cystitis should see a doctor to get treated. They should not be treated with over-the-counter remedies. Women who have cystitis for the first time should also see a doctor. The same goes for women who have recurrent bouts of cystitis, cystitis that does not clear up within a week or who are suffering from severe symptoms.
Women are eight times more likely than men to get cystitis (because a woman’s urethra is shorter and closer to the anus than a man’s). Up to 15% of women get cystitis each year, and 50 % of all women have cystitis at least once in their life.
If your cystitis doesn't improve within a day or two (despite the use of home remedies for bladder infection), you should consult a doctor, so that he can prescribe you the right antibiotics – whichever type is best for you. Additionally, you should seek medical help if you experience the symptoms of severe – or acute – cystitis:
- Fever and chills
- Blood in the urine
- Pain or discomfort in your lower back
People who have a history of kidney infections, heart problems or recurrent bladder infections should consult their doctor when suffering from cystitis.
This is also necessary for patients with diabetes, because bacteria thrive in sugar. There might be an increased risk that the infection spreads to the kidneys. Pregnant women who have a bladder infection also need close medical attention.
Most urine infections are caused by germs from the bowel being transferred from your anus (back passage) to your urethra (the tube that your bladder sends urine through when you urinate). Certain types of bacteria thrive in urine and rapidly multiply, spreading the infection.
Most of the time, this happens when people don't go to the toilet often enough. This results in “left-overs” of urine and bacteria in the bladder that lead to an infection. So, remember to empty your bladder regularly and as completely as possible. This problem may also occur in people who don't drink enough. This can cause the urine to become more concentrated in the bladder, until it can be flushed out. This can also result in bacterial infections. It's possible that a blockage somewhere in your kidneys, bladder or urethra cause cystitis as well, for example because of kidney stones or prostate problems in men.
Risk factors in women: it's estimated that 30-50% of women will have cystitis at some time in their life. Here's a list of all the risk factors that contribute:
- Pregnancy – hormonal and physical changes can contribute to the infection;
- Menopause – hormonal changes can contribute;
- Using the contraceptive diaphragm;
- Sexual activity (increase the chances of having bacteria pushed in the urethra) and having unprotected sex with new partners (infection due to the body's unfamiliarity to new bacteria carried by the new partner);
- Diabetes – excess sugar facilitates the reproduction of bacteria;
- Impaired immune system – i.e. when natural defenses are down (e.g. because of an illness or a cancer treatment).
Risk factors in men: male bladder infection is usually a symptom of a more severe disease. It therefore requires a visit to the doctor. It is sometimes the sign of an obstruction somewhere within the urinary tract. STIs can also cause bladder infection in men.
Other risk factors:
- Foreign bodies in or near the bladder (tubes, kidney stones,...);
- Strong allergies to vaginal creams and other hygiene products;
- Vaginal infections, such as thrush;
- Sexually transmitted infections (STIs), such as chlamydia, can increase the risks of getting cystitis.
There is also some evidence that using a spermicide destroys the normal vaginal flora, including its bacteria, which can lead to an increase in the number of foreign bacteria which will then become the source of bladder infection.
Cystitis occurs much less frequently in men. Sexually active gay men are more likely to get it than other men. Cystitis can be serious, because it can be a sign of:
- An infection of the bladder or prostate (the gland between the penis and the bladder)
- A blockage/obstruction in the urinary tract (e.g. from a tumour or an enlarged prostate)
- Men who get cystitis should therefore see a doctor as soon as possible.
This page covers bacterial cystitis. However, there are other types of cystitis:
Interstitial cystitis – causes recurring discomfort in the bladder and pelvic area. It comes with a frequent and urgent need to urinate. The pain that it causes, along with other symptoms, vary from person to person. Women may find it even more painful when they are menstruating. Interstitial cystitis is normally diagnosed around age 40 and 90% of people who have it are women. It is treated with painkillers, bladder distension (increasing the bladders size by filling it), bladder instillation (filling the bladder with a solution to sooth irritation) or surgery.
Radiation cystitis – this is damage caused to the bladder by radiation therapy (such as when used to treat cancer in the pelvic organs). Symptoms include blood in the urine and pain. Treatments include painkillers, Hyaluronic Acid, Elmiron and Botox injections.
Chemotherapy Induced cystitis – caused by immunotherapy given directly to the bladder. Treatments include Hyaluronic Acid and Elmiron.
Cystitis Glandularis/Cystitis Cystica – In cystitis cystica, the lining of the bladder comes out in tiny blisters, in cystitis glandularis the lining is thicker over the blisters, giving a cobblestone appearance. Both are usually the result of a chronic urine infection. Treatment is usually long term antibiotics.
There are different approaches to treat cystitis. These vary from self help to antibiotics. The first option is not taking any medication. Often your immune system will clear the infection by itself. Cystitis often goes away without treatment within a few days, but if you don’t take antibiotics, it can last for up to about a week.
The second option is a short course of antibiotics. If you need this, your doctor will probably suggest a course of 3-5 days of antibiotics. Nitrofurantoin are the antibiotics used to treat cystitis. You should to see an improvement about a day after you start taking the medication. It is thought that taking antibiotics reduces the length of symptoms by about a day. You can ask your doctor to give you a prescription for antibiotics as a standby, to take if your symptoms get worse or don’t improve.
If you’re pregnant and experiencing symptoms of cystitis, please see your doctor. Your doctor will help you find a treatment which won’t cause any harm to your baby.
The most common side effects of nitrofurantoin are feeling or being sick, feeling dizzy and having diarrhoea. Nitrofurantoin might darken the colour of your urine, but this is normal and not anything to worry about.
Tell your doctor, before taking these medications, if you:
- are pregnant, breastfeeding or trying for a baby
- think you might have glandular fever
- have problems with your liver or kidneys or your breathing
- are diabetic
- are anaemic or have low levels of vitamin b or folic acid
- have peripheral neuropathy
- have porphyria or glucose 6-phosphate dehydrogenase (G6PD) deficiency
- are taking other medicines
- have ever been allergic to a medicine
- if you are taking a contraceptive pill (you may need to use additional types of contraception)
NHS (2018). Cystitis. [online] Available at: https://www.nhs.uk/conditions/cystitis/ [accessed 28th February 2019].