Historically, #cystitis generally was a problem for women, who otherwise were well. They suffered in silence, drank water like fish, and, perhaps, also guzzled K+ citrate and/or cranberry juice, for what they thought they were worth. Antibiotics’ arrival brought simple and convenient “pill-popping,” treatment with most getting symptom relief, while the others continued suffering quietly, so cystitis garnered little medico-scientific interest. Today, cystitis presents very d

The distal urethra is a residency for #bacteria, mostly commensals, but sometimes potential uropathogens move in. #Catheterisation hygiene cleans the skin around the urethral meatus but does not remove bacteria residing in the distal urethra. Many people have focused time, effort and money on coatings that are supposed to prevent such bacteria surviving #catheter entry into the #bladder. Such a #coating would need to kill the potential pathogens before they are transferred fr

By Prof. Scott Glickman If a drug treatment for #cystitis is approved by a patient safety regulatory agency, without evidence that it can produce cure, who, if anyone, actually is, or should be responsible for an infection recurrence with it? I ask because I see no convincing evidence that any approved oral #antibiotic treatment has ever come with evidence that it reliably cures cystitis (i.e. produces pathogen annihilation). Of course, I see symptom recovery, but notwithst

Homeostatic mechanisms optimise our cellular chemistry. #antibiotics treatments are developed specifically to work in our narrow-band homeostatic chemical milieu to be delivered through blood to #infection sites for intimate combat with #bacterial invaders. With #cystitis, the bacteria are planktonic in urine and attached to urothelial cell membranes, so are too far away to be influenced by that approach. For #antibiotic tablets to have any chance to be effective against cy

I ask you to start the new year with a fresh look at cystitis and its management. While all the following are true: • The bladder is a soluble waste storage “bin.” • Urine is liquid metabolic waste dross. • Cystitis is a scourge. • Antibiotic stewardship must protect against over-use and • Symptom relief and clinical recovery are treatment goals. These facts haven’t helped us address cystitis recurrences, urosepsis or reduce AMR, so consider these facts, too: • Cystitis trea

From our Chief Medical Director, Professor Scott Glickman: With people working on AMR from cystitis treatments, I would be grateful to discuss the following conundrum. My analysis indicates that the oral/systemic route of administration is critically flawed by rate-limited initial drug filtration and ureteric drip-feed of antibiotic into urinary pools of sufficient volumes to delay it reaching MIC, and with its fluctuant pH likely dynamically altering MIC in-vivo as well, thu

From our CMO Professor Scott Glickman Colleagues: In medical and surgical services spanning primary through intensive care, we are dogged by UTI with their acute and long-term complications: treatment failures, recurrences, urosepsis, antimicrobial resistance (AMR) and high costs. Despite continuous improvements in antibiotic stewardship, these problems show little sign of abating. Something else must be involved. Antibiotic overuse and misuse shouldn’t be blamed exclusively