Although the rate of bladder infections or cystitis in younger men is very low compared to that in women, it rises dramatically in older men. Enlarged prostate, kidney stones and abnormal narrowing of the urethra owing to catheterization, surgery or infection are the major contributing factors to bladder infections in men. Cystitis in men is characterized by frequent, painful urination, low-grade fever and bloody or cloudy urine with a strong odor.
Antibiotics and Antifungals
Antibiotics are the drugs of choice to treat bladder infections caused by bacteria, whereas antifungals such as amphoterecin B and fluconazole may be useful in treating candida bladder infections. The choice of the drug, duration of treatment, dosage and route of administration depend on the type of pathogen responsible for the infection and the severity of the condition. The Merck Manual for Patients and Caregivers points out that although antibiotics can treat bladder infections in men efficiently, most of them cannot penetrate well into the prostate. Hence, patients may have to take antibiotics for weeks at a time to prevent recurrent bladder infections caused by prostate bacteria.
Doctors initially prescribe a broad-spectrum antibiotic that is effective against a variety of bacteria. Once results of laboratory tests are available that identify the causative organism, patients may receive a prescription for a more specific antibiotic. Beta lactam antibiotics such as ampicillin and amoxicillin and cephalosporins such as ceftriaxone and cefotaxime are the most common antibiotics doctors use to treat bladder infections. Patients allergic to penicillin are allergic to these antibiotics as well, however. Penicillin-allergic patients can take trimethoprim/ sulfamethoxazole, nitrofurantoin, ciprofloxacin and norfloxacin.
Common side effects associated with most antibiotics include nausea, vomiting, diarrhea, loss of appetite and dizziness. Patients should talk to a physician if the side effects worsen or do not improve with time.
Anti-Pyretics
Doctors treat the low-grade fever associated with cystitis using anti-pyretics such as acetaminophen, ibuprofen and aspirin. Patients can obtain anti-pyretics at the pharmacy without prescription and take them as needed. Hospitalized patients who are seriously ill may receive these drugs intravenously. Side effects are rare, but overdose can cause nausea, vomiting and upset stomach. A life-threatening condition known as Reye's syndrome, characterized by the swelling of the brain and liver, can occur in children younger than 18 who take aspirin. The Mayo Clinic warns against the use of aspirin in children.
Fluids
Fluids can help flush bacteria from the bladder and maintain blood volume, which is essential for the functioning of the immune system. Doctors recommend that men with bladder infections drink eight to 10 glasses of water daily. Patients may require intravenous fluids to treat serious bladder infections.
Anticholinergics
The Merck Manual for Patients and Caregivers recommends anticholinergic drugs such as oxybutynin and tolterodine to relieve the symptoms of frequent and painful urination. Men with an enlarged prostate should use these drugs with caution, as they may cause retention of urine.
Surgery
The "New York Times" Health Guide states that doctors occasionally recommend surgery to treat cases of recurrent cystitis caused by kidney stones or anatomical abnormalities that lead to retention of urine and, as a result, promote the growth of bacteria.
