Cystitis is the infection of the urinary bladder that is characterized by painful and frequent urination, smelly urine and low-grade fever. Most cases of candida cystitis are associated with catheter use. However, asymptomatic colonization of candida within the bladder is common, and treatment of candida cystitis is recommended only for those cases in high-risk patients or cases that are accompanied by symptoms.
Antifungals
Antifungals, such as amphotericin B and fluconazole, are the most common drugs used to treat candida cystitis. Fluconazole belongs to a class of antifungals known as triazole medications, and they act by slowing the growth of candida species. Fluconazole is usually taken orally once per day for seven to 14 days, and common side effects include headache, diarrhea, heartburn and stomach pain. In severely immunocompromised patients, intravenous amphotericin B may be administered along with fluconazole. According to MedlinePlus, amphotericin B is added to the intravenous fluid that drips for 2 to 6 hours through a hypodermic needle or catheter. Amphotericin B may cause side effects including nausea, vomiting, dizziness and headache.
The Merck Manual for Healthcare Professionals also recommends flucytosine to treat mild cases of candida cystitis not involving the kidneys. However, most fungi, including candida, may develop resistance against flucytosine, especially when administered alone.
Anticholinergic Drugs
Anticholinergic drugs have the ability to relieve the symptoms of frequent and painful urination that are commonly associated with candida cystitis. Drugs such as oxybutynin and tolterodine act by relieving bladder spasms that cause the feeling of urgency, while other drugs such as phenazopyridine reduce the pain associated with urination. However, a study published in the July 2009 edition of the Archives of Internal Medicine has found increased risk of cognitive decline and dementia in elderly patients taking anticholinergic drugs; hence its use in patients of that age group should be carefully considered.
Antipyretics
Low-grade fever and mild abdominal pain are some of the common symptoms of candida cystitis, and most patients manage these without any medications. Antipyretics such as acetaminophen, ibuprofen and aspirin may be used to treat both fever and pain, if required. These medications are available without prescription. According to MayoClinic.com, aspirin should not be used in children younger than 18 years of age due to the risk of developing a fatal condition known as Reye's syndrome, which is characterized by swelling of the liver and brain.
Hydration
Drinking large amounts of fluids, especially water, is a simple and effective way to flush out candida from the bladder. Fluids may be administered intravenously if necessary.
References
- The Merck Manual for HealthCare Professionals: Fungal Urinary Tract Infections
- MedlinePlus: Amphotericin B Injection
- "Archives of Internal Medicine"; Drugs With Anticholinergic Properties, Cognitive Decline, and Dementia in an Elderly General Population; Isabelle Carrière et al; July 2009
- MayoClinic.com: Reye's Syndrome
