Chronic cystitis: how to prolong the relapse-free period?

Introduction. Chronic cystitis predominates in the structure of urinary tract infections (UTIs). International guidelines are mainly focused on the treatment of acute uncomplicated cystitis; the approaches for managing patients with chronic cystitis has not been sufficiently developed.

Material and methods. A total of 91 patients were included in prospective multicenter randomized comparative controlled study. They were divided into three groups. In the group 1, 32 women received only standard antibiotic therapy for 5 days. In the group 2, 28 patients (received standard therapy plus rectal suppositories Superlymph^® 25 IU 1 time per day for 10 days). In the main group, 31 women received standard therapy in combination with the use of rectal suppositories Superlymph^® at a dose of 10 IU 1 time per day for 20 days. Standard antibiotic therapy included fosfomycin trometamol 3.0 g once and furazidin 100 mg three times for 5 days.

To assess the long-term results, patients were invited for a follow-up 6 months after the end of therapy.

Aim. To determine the long-term results of combined etiologic and pathogenetic therapy, including Superlymph^® rectal suppositories at a dose of 10 U and 25 U, in patients with chronic cystitis.

Results. Six months later, 82/91 (90.1%) women were examined to assess the long-term results.

At 6 months, in group 1 a relapse of the cystitis developed in 17 women (60.7%) after an average of 67.3±9.4 days. In group 2, recurrence was observed in 12 patients (44.4%), and the relapse-free period was longer, averaging of 84.3±9.2 days. The best results were demonstrated in the main group, in which the relapse-free period lasted an average of 123.5±8.7 days, and a relapse developed in only 8 cases (29.6%). In 19 patients (70.4%) there were no symptoms after six months. Differences between groups were highly significant (p<0.001). In all groups, none of the patients had more than one recurrence of the cystitis during the follow-up.

Conclusion. Combined antibiotic therapy results in the absence of recurrence within six months in 39.3% of patients with chronic cystitis. Complex etiologic and pathogenetic therapy, including Superlymph^® rectal suppositories, allows to significantly reduce the number of recurrences and prolong the relapse-free period. Among the patients who received a course of local cytokine therapy at a dose of 25 units for 10 days, 55.6% did not have a recurrence of chronic cystitis within 6 months. In the group of patients who, along with etiologic therapy, received Superlymph^® rectal suppositories at a dose of 10 IU for 20 days, a relapse was absent in 70.4% of patients.