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Empirical treatment of uncomplicated cystitis

BMJ 2001; 323 doi: (Published 24 November 2001) Cite this as: BMJ 2001;323:1197

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  1. Anders Baerheim (, senior lecturer in general practice
  1. University of Bergen, Bergen 5009, Norway

    Acute uncomplicated cystitis in healthy non-pregnant women is a common problem, affecting 10-15% of women each year.1 It is readily managed by treatment for up to three days, and courses of three days or less seldom give rise to the development of bacterial resistance in the gut. 2 3

    Uncomplicated cystitis accounts for a substantial part of all prescribed antimicrobials. Results of standard treatment in general practice have until recently been satisfying: cure rates for most antibiotics have varied between 85% and 95%.4 Rising levels of resistance cause concern, because the increase may lead to the liberal use of newer antimicrobials with broader spectrums, resulting in increased resistance to these drugs too. Local variation in levels of community based prescribing may be reflected in changes in local levels of antibiotic resistance in uropathogens.5

    A recent national survey has described susceptibility among 103 223 isolates of uropathogens from microbiological laboratories in nine geographical regions of the United States.6 The resistance …

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