Magazine 14 May 2024

Persistent cystitis after antibiotic: why it happens and how to deal with it

My dear friend,

Have you ever had symptoms of your cystitis persist even after treatment with antibiotics?

If so, you are not the only one. Urinary tract infections (UTIs) are common and can be effectively treated with antibiotics. However, in some cases, symptoms may persist despite treatment, causing discomfort and discouragement to patients.

There are several reasons why UTI symptoms may persist despite treatment with antibiotics, and in this article we will try to examine them in detail.

Finally, I will give you some tips to prevent cystitis and relieve symptoms naturally, without the use of antibiotics.

Do antibiotics have no effect on your cystitis? Here’s how to behave

Why symptoms of urinary tract infections may persist even after antibiotics

Whether it is cystitis or, more generally, a urinary tract infection (UTI), antibiotics are the first line of treatment.

And it is not strange that some doctors prescribe an antibiotic without first performing a urinoculture. This is because nearly 80% of cystitis is caused by E. coli, and a urine culture will likely confirm that it is the culprit.

Unfortunately, however, antibiotic treatment does not always respond as expected.

There are three main reasons why this can happen:

  1. An antibiotic-resistant strain of bacteria is the cause of cystitis;
  2. another type of bacteria, fungus or virus may be the cause of the infection;
  3. it may be another condition that has similar symptoms to those of UTIs.

But let’s go in order.

#1 Resistenza agli antibiotici

When you have an antibiotic-resistant UTI, it means that the bacteria causing the infection do not respond to antibiotic treatment.

This happens when bacteria evolve in response to frequent or constant use of antibiotics.

People with underlying medical conditions or chronic UTIs are those most at risk for antibiotic resistance.

#2 Antibiotici sbagliati

When a urine test is performed without an additional urinoculture, there is a risk that the antibiotic prescribed for the infection is not the right one.

This can happen when the UTI is caused by a less common bacterial strain, or even a fungus or virus.

#3 Diagnosi errata

In some cases, UTIs do not respond to antibiotics because, trivially, they are not UTIs at all.

Instead, another underlying condition could cause symptoms similar to those of these infections, such as:

  • acute cystitis;
  • Interstitial cystitis;
  • Overactive bladder;
  • renal infection;
  • kidney stones;
  • vaginitis;
  • Chlamydia;
  • gonorrhea;
  • trichomoniasis;
  • genital herpes;
  • bladder cancer;
  • prostate cancer.

Both cystitis and kidney infection can be caused by bacteria from a UTI that have spread to the bladder or kidneys.

Like UTIs, these types of infections are often treated with a course of antibiotics. However, some of the potential causes of antibiotic failure for UTI also apply to these infections.

What to do if the infection recurs immediately after antibiotics?

As I mentioned earlier, UTIs that do not respond to antibiotics will likely require a urinoculture to determine what bacteria are causing the infection.

If it turns out that the cause of UTI is another type of bacteria, fungus or virus, the doctor will recommend an alternative treatment.

In addition, lifestyle changes, such as quitting smoking or consuming less alcohol, can reduce the frequency and severity of UTIs.

But let us elaborate.

So here are some tips to follow in case the infection recurs immediately after taking antibiotics.

Practice good intimate hygiene 🫧

Good hygiene after urination and bowel movements can help prevent bacteria from entering the urinary tract.

Among the hygiene recommendations, I list the most important ones:

  • Do not hold your pee for too long when you feel the need or urge to urinate;
  • after a bowel movement, always wipe from front to back (and NEVER vice versa);
  • pee after intercourse (only if you really feel the urge).

Stay well hydrated πŸ’¦

Remember to drink plenty of water and urinate regularly. This can help eliminate harmful bacteria in the body.

Research shows that increasing daily water intake can reduce the risk of recurrent UTIs.

Taking a shower instead of a bath πŸ›€πŸ»

Bacteria grow faster in warm, lukewarm water, which is why many doctors recommend avoiding hot tubs and baths and taking showers instead.

Also, the soap in many bubble baths can irritate the urinary tract-that’s why I always recommend using mild detergents, such as our Dimann Soft.

Avoid scented or irritating products and overly tight-fitting clothes πŸ‘–

You may like perfume, but scented tampons, pads, bubble baths, toilet paper, deodorants, and laundry detergents can alter the balance of bacteria in the vagina, causing irritation or infection.

Try to pay attention to the products and garments you use, checking that they are made of breathable and nonaggressive materials. πŸ™πŸ»

How to treat cystitis without resorting to antibiotics?

Have you ever heard of D-mannose?

It is a natural sugar that prevents the adhesion of bacteria, – such as Escherichia coli (E.coli), the main cause of urinary tract infections – to the epithelium of the urinary tract, preventing contact between the microorganism and the urinary epithelium and the subsequent development of diseases such as cystitis.

This was demonstrated in a study published March 5, 2022 in the scientific journal Nutrition Journal, which also emphasizes the safety of D-mannose as well as the urgency of finding an alternative treatment for recurring diseases due to antibiotic resistance.

The same study points out that D-mannose usually shows rapid improvement in cystitis symptoms due to its high absorption within 24 hours of the first dose, but it is advisable to continue with the entire course of treatment.

Do you want to know more? If you have any questions, you can always write to me, I would be happy to help you! πŸ₯°

In this article we talked about…

  • The antibiotic prescribed for the infection may not be the right one, especially if an additional urinoculture is not performed to identify the pathogen.
  • Resistance to antibiotics by the bacteria causing the infection is another reason why the prescribed antibiotic may not work.
  • In some cases, persistent symptoms of urinary tract infections may not be due to a UTI, but to other conditions with similar symptoms.
  • To prevent urinary tract infections, it is important to practice good intimate hygiene, drink plenty of water, take showers instead of baths, and pay attention to the products and clothes used.
  • D-mannose is a natural sugar that can be used to prevent and treat cystitis because it prevents bacteria from adhering to the urinary tract.

FAQ on resistance of infections to drugs


What are the main reasons why a UTI might not respond to antibiotic treatment?
There are three main reasons why a UTI may not respond to antibiotic treatment: antibiotic resistance of the bacteria causing the infection, use of the wrong antibiotics to treat the infection, or misdiagnosis.

What can be done if the urinary tract infection recurs immediately after antibiotics?
If the urinary tract infection recurs immediately after antibiotics, a urinoculture can be performed to determine the cause of the infection. In addition, drinking plenty of water, eating fruits and vegetables, and consuming probiotics are actions that can help prevent urinary tract infections.

Are there alternative solutions for the treatment of cystitis besides antibiotics?
Yes, an alternative solution for the treatment of cystitis is the use of D-mannose, a natural sugar that prevents bacteria from adhering to the urinary tract. One study showed that D-mannose can improve cystitis symptoms within 24 hours of the first dose, but it is advisable to continue with the entire course of treatment.

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