Cystitis (Urinary Tract Infection)

Urinary Tract Infection

Cystitis

Please be advised, as a written consultation service, our clinical criteria for issuing antibiotic prescriptions for potential urine infections is more strict than the clinical judgment that may be used during a face-to-face consultation

Urinary tract infections are caused by bacteria getting into your urethra (tube that connects the bladder to the external opening) or bladder. The bacteria usually comes from your gut/ bowels and can cause infections in different parts of the urinary tract.

1. Kidney (Pyelonephritis): This is caused by infection and requires prompt medical assessment. You can feel quite unwell with this condition (temperature, flank/ side pain, vomiting, blood in the urine).
2. Bladder (cystitis):This can be caused by infection (requires antibiotics) or inflammation. It is a common type of urinary tract infection (UTI) in women.
3. Urethra (urethritis):This is often caused by inflammation rather than infection and can mimic the symptoms of cystitis.

If you suffer from repeated episodes of cystitis/ urine infections you should arrange an appointment with your local GP for assessment.This would include checking a urine sample for specific bacteria and may include a sexual health screen. (Some sexually transmitted infections can have symptoms mimicking urine infections).

The main symptoms of cystitis include:

• Pain, burning or stinging when you pass urine
• Needing to pass urine at night
• Passing urine more often than usual
• Needing to pass urine immediately (urgently)
• Dark, cloudy or strong-smelling urine
• Pain low down in your tummy (not in your sides)
• Peeing blood stained urine *
• Feeling feverish along with other urinary symptoms*

*If you are feeling unwell, have a temperature or are peeing blood, this service is NOT suitable for you, a video consult or a visit to your GP would be needed

Women tend to get cystitis more often than men because the female urethra (tube that brings urine from the bladder out of the body) is much shorter than it is in males and the female urethra sits closer to the back passage compared to males. This means that bacteria can get into the bladder more easily. E.Coli bacteria, from the bowel, is the most common cause of cystitis.

Some things can increase your risk of developing cystitis:

• Having sex
• Wiping from back to front, instead of front to back, after going to the toilet
• Being older than 65 years (10% of women over this age report having a UTI in the last 12 months)
• Hormonal conditions such as Cushing’s syndrome, or thyroid problems
• Pregnancy
• Using a diaphragm / spermicide & condoms for contraception
• Diabetes
• A weak immune system

Mild cases of cystitis often get better without any treatment (can take up to 5 days) and antibiotics are not always necessary.

It may help to do the following:

• Take paracetamol or ibuprofen if you are having pain in your tummy
• Cystopurin sachets (available over the counter in your pharmacy)
• Drink plenty of water, minimum of 2.5 litres
• Hold a hot water bottle on your tummy or between your thighs
• Avoid having sex until your infection has cleared entirely
• Wipe from front to back when you go to the toilet
• Gently wash around your genitals with a skin-sensitive soap or soap substitute

Many women find cranberry products helpful to control symptoms. There is no medical evidence to support their use, but they may be worth a try!

If your symptoms are unpleasant and persisting for more than 48 hours despite these measures, antibiotic treatment can be considered.

Medications

If clinically appropriate, we can provide treatment with an antibiotic called Nitrofurantoin. Nitrofurantoin will begin to work within 24 hours usually. Most patients do not experience side effects with this, but occasionally diarrhea and dizziness may occur.

Please note:Nitrofurantoin is NOT SUITABLE for patients with a decreased kidney filtration rate (estimated glomerular filtration rate, or eGFR). If your eGFR is less than 45, this medication is not suitable for you as it will not be as effective at treating the infection and can increase your risk of developing significant side effects (such as nerve, lung and kidney problems)

*If you are unsure about what this is and need further information, please contact us so that we can help to clarify

We are NOT able to arrange prescriptions for OTHER antibiotics via this service - a video consultation with one of our GPs will be necessary if alternative treatment is required.

• Please be aware that antibiotics should only be used if necessary.
• When antibiotic tablets are taken, they affect our gut bacteria
• The gut bacteria can then become resistant to the antibiotics we have taken. (This means that the antibiotics are not effective against these bacteria
• Our gut bacteria is often the cause of female urine infections.
• Our gut bacteria is often the cause of female urine infections.
• This is one of the reasons; it is important that we have a good clinical indication for prescribing antibiotics for urine infections

Who is this service for?

This service is suitable if you are:

• A women between the ages of 17 and 65
• Experiencing specific clinical urinary symptoms >48hours

This service is NOT suitable for you if you are:

• Male
• A child under the age of 17
• A female over the age of 65
• Pregnant (or suspect you could be pregnant) or breastfeeding
• Having symptoms of fever, shaking chills, vomiting or flank pain (pain in the sides)
• Seeing blood in your urine
• Experiencing vaginal bleeding or abnormal vaginal discharge
• Using a urinary catheter (including self catheterisation and permanent catheters)
• Aware your kidney filtration rate (eGFR/ estimated glomerular filtration rate) is less than 45 mL/min
• Seeking a prescription for medications other than Nitrofurantoin e.g. Trimethoprim, Cefalexin ,Fosfomycin. These will not be issued via this service.
• Requiring a medical certificate due to the urine infection. (Please note, we cannot issue retrospective medical certificates.)

How the service works

• Just €30
• Prescription sent to your chosen pharmacy via secure email (Healthmail) within minutes of approval
• No risk, 100% refund if our Doctors cannot help you
• Online consultations with Irish based doctors
• Valid in any Irish pharmacy to buy your medication

Note: We can only ever prescribe for this treatment for patients that are at least 17 years of age.

The accuracy of the information you provide is very important for the safe prescribing of the most suitable type of medication

The information that you provide is covered by the same patient-doctor confidentiality as in a normal face to face consultation.