Doxycycline improves cystitis symptoms in women

Women with interstitial cystitis know too well that the bladder condition is hard to treat, so much so that their doctors can become frustrated trying to find something that relieves the problem. Now comes word that a common antibiotic might work.

According to a report in The Journal of Urology, treatment with doxycycline improves the need to urinate urgently and frequently, as well a chronic urethral and/or pelvic pain, in more than two-thirds of women with those symptoms,

As the authors note, a diagnosis of interstitial cystitis often signals the start of a chronic, progressive, and untreatable course.

Dr. Fiona C. Burkhard and colleagues from the University of Berne in Switzerland investigated the benefits of doxycycline treatment for 103 women with urinary urgency, frequency, and pelvic pain of unknown origin. They all had the white patches on the wall of the bladder - called trigonal leukoplakia - that is characteristic of interstitial cystitis, but did not have any conventional urinary tract infections.

The women took 100 milligrams of doxycycline twice daily for two weeks, then once daily for another 2 weeks. Their sexual partners were also treated with a 2-week course of doxycycline.

After an average of three months following treatment, 30 percent of women considered themselves cured and 41 percent reported improvement, the report indicates. Twenty-eight percent of women reported no change and 1 percent described a worsening of symptoms.

Among 31 women who consented to follow-up bladder examination, trigonal leukoplakia had resolved completely in 8 and decreased in extent in 12, the researchers note. The degree of leukoplakia was unchanged in 10 women and increased in one.

"We think that trigonal leukoplakia is associated with chronic infection and this supports us," Burkhard told Reuters Health. She said that, even without a bladder exam, her group treats women who have typical symptoms of interstitial cystitis.

"Before stigmatizing patients with the diagnosis of a potentially incurable disease, a trial run with doxycycline is feasible," Burkhard said.

She added that it is also important to treat the woman's partner, as symptoms often commence "after the beginning of a new relationship."

SOURCE: Journal of Urology, July 2004.