Increasing cystitis cases linked to less antibiotics being prescribed by GPs
In 2019, more than 170,000 urinary tract infections accounted for hospital admissions in the UK alone. They represent an incredibly common range of conditions affecting the urinary system, from cystitis (the most prevalent), to infections of the urethra and kidneys (pyelonephritis).
And, while these infections have always been common – particularly among women, and the older population – statistics gathered over the past twenty years demonstrate an exorbitant rise in the number of cases, particularly in those that are serious enough to require hospitalisation.
In persistent cases, we have seen an increase in excess of 166% between 2001 and 2019 – which, given the toll it can take on a patient’s life, and the risk of much more serious complications, is an incredibly worrying statistic.
What is Cystitis?
When bacteria enter into the urinary tract, it can spread to the bladder and begin to multiply, causing a wide range of symptoms to varying degrees of severity. The condition is much more prevalent in women, although, in general, cases remain relatively minor; for men, a diagnosis requires immediate medical attention.
For many, it can cause relatively minor discomfort in the lower abdomen, urine that is discoloured and strong-smelling, and an inability to empty the bladder fully which, in turn, leads to a continuous urge to go to the toilet. These cases are typically treated with antibiotics, and do not require further medical attention.
In more severe cases, or instances where the infection is left untreated, serious complications can arise; what is, at first, thought to be a run-of-the-mill cystitis infection can spread to the kidneys and lead to sepsis. These patients will require hospitalisation, and a more aggressive form of treatment in order to prevent potentially fatal complications, such as organ failure.
How Can it be Treated?
Two antibiotics are commonly used to treat cystitis – Nitrofurantoin, as a first line of defense, and Trimethoprim. Some research has been made into the efficacy of nonantibiotic alternatives but, thus far, very little progress has been made into identifying a treatment that will prove as effective as antibiotics.
What is the Link Between Rising Cases and Antibiotic Resistance?
There are, at this point in time, two leading theories pertaining to the marked increase in cases we have seen over recent years.
In one camp, experts are suggesting that a drive to decrease the rate of antibiotic prescriptions is directly correlated to the rise in more serious infections. Unfortunately, mitigating the impact of antibiotic resistance, in this instance, means depriving patients of the only treatment that has proven effective against cystitis, thus rendering them more vulnerable to chronic issues and the need for hospitalisation.
At the other end of the spectrum, some suggest that it is antibiotic resistance which should be blamed for the rise in serious cases. Under this theory, while patients are still being prescribed antibiotics, long-term usage renders them less effective against urinary tract infections; those who have suffered before will, they suggest, find it much harder to get rid of the infection with the same treatment in the future.
Of course, understanding the root cause of the issue is incredibly difficult, and it is likely that the two factors have coalesced to create a double-bind for any patient in need of treatment.
What Help is Available to Those Suffering from Cystitis?
With more uncertainty building around the ways in which cystitis is addressed by GPs, it is important that women understand some of the ways in which they can prevent cystitis.
For many women, sexual intercourse can push bacteria into the urethra, and passing urine immediately after sex can offer an effective safeguard against a possible infection. Similarly, preventing a significant build-up of moisture by choosing breathable cotton underwear and avoiding tight, restrictive clothing can also help to prevent infection.
Unfortunately, many women will find that even the best precautions fail to prevent a bout of cystitis – and that a trip to the GP can prove to be a frustrating experience if they are unwilling to offer antibiotics to clear the infection before it demands more serious attention.
In these instances, women who have previously been diagnosed by their general practitioner can instead choose to buy antibiotics online, circumventing the need for further appointments and issues in precuring an effective cystitis treatment.
The ongoing struggle to assuage the issue of antibiotic resistance is one of the most pressing concerns in the world of medicine today, and, unfortunately, those suffering from continued cases of cystitis are mong the casualties of this fight. Until we can find an effective alternative, antibiotics remain essential to the thousands of women suffering from this infection each year, and they must be made available to patients sooner rather than later.