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#Cystitis: Yesterday, Today and Tomorrow
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

Scott Glickman
Aug 7, 20242 min read
UroPharma has successfully completed another major step
Colleagues, I am pleased to inform you that UroPharma has successfully completed another major step on the road to bringing our...

Scott Glickman
Jun 24, 20242 min read
The new UK anti-AMR strategy plan
Colleagues I’ve been wading through the UK #governments second 5-year anti-AMR action plan, “Confronting #AntimicrobialResistance 2024-20...

Scott Glickman
Jun 6, 20241 min read
Psychology in #Urology
Unconscious bias is a systematic cognitive error in decision-making, about which the decision-maker is unaware. Unconscious bias against #bladders is common, especially infected ones. Compared to other organs, progress in #cystitis management has barely changed for ~ ¾ of a century, despite incidences increasing, recurrences abounding, and AMR becoming more pervasive, because of antiquated, flawed and haphazard treatments. We challenge “haphazard” through #antibioticsteward

Scott Glickman
Apr 22, 20242 min read


A conundrum of #catheter coatings and #CAUTI
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

Scott Glickman
Feb 5, 20241 min read
Responsible antibiotic stewardship
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

Scott Glickman
Jan 26, 20241 min read
More on #Cystitis and #AMR
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

Scott Glickman
Jan 23, 20242 min read
Cystitis and its treatment (by Prof. Glickman)
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

Scott Glickman
Jan 8, 20241 min read
AMR issues from cystitis treatments
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

Scott Glickman
Jan 3, 20241 min read
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