Managing Cystitis in Clinical Practice: From acute infection to recurrence prevention
Date
23 Sep 2026
Author/Presenter
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Urinary tract infections (UTIs) affect more than 404.6 million individuals globally according to the most comprehensive and widely accepted estimate.1 Premenopausal women are 20 to 40 times more likely than men of the same age to develop an infection.2 Approximately 50% of women will experience at least one UTI during their lifetime and, despite antibiotic intervention, 20-30% will go on to experience another medically diagnosed UTI within 3-4 months of the initial infection.1 The prevalence of recurrent urinary tract infections increases after menopause, largely because of oestrogen deficiency and associated changes in the genitourinary tract.1
Key highlights
- Recurrent cystitis is defined as ≥2 culture-confirmed episodes within six months or ≥3 within 12 months.
- Biofilms can make uropathogens up to 1,000 times more resistant to antibiotics, contributing to persistence and recurrence.
- Cranberry PACs have the strongest evidence for reducing recurrent cystitis, while zinc targets bacterial virulence and vitamin D and Beta-glucans support host immune function.
- For first-time uncomplicated cystitis, complementary therapies may be used alongside antibiotics from day one; recurrent cystitis should be confirmed with urine culture before treatment.
- Red flags and complicating factors require prompt medical assessment and referral.
- Collaborative care between the GP, pharmacist and complementary practitioner supports effective treatment and long-term prevention