Uncomplicated Cystitis In Women Research Articles

Therapeutic strategies for uncomplicated cystitis in women.

Uncomplicated cystitis is affecting many women of all ages and has a great impact on the quality of life, especially in women suffering from recurrent, uncomplicated cystitis. By far the most frequent uropathogen, E. coli, may have acquired increasing resistance against a variety of oral antibiotics, which may differ between countries and regions. Therefore, local resistance data are important to be considered. On the other hand, non-antibiotic therapy has also become an option which should be discussed and offered to the patient. In patients suffering from recurrent uncomplicated cystitis, individual risk factors and possible behavioral changes should first be taken into account. Non-antimicrobial prophylactic strategies shown to be successful in well-designed clinical studies are the next options. Long term antibiotic prophylaxis, however, should only be considered as a last option. For some of those patients self-diagnosis and self-treatment may be suitable, e.g. by using a recognized questionnaire.

Občutljivost za antibiotike pri povzročiteljih nezapletenega cistitisa v Sloveniji

Background: Acute uncomplicated cystitis in women is a common reason for antibiotic treatment in the outpatient clinic of family doctors. Microbiological diagnostics is not indicated; treatment is generally empirical and based on guidelines and recommendations. Therefore, we do not have representative data on the incidence and sensitivity of pathogens from regular laboratory work. Special targeted research is needed.
 Methods: We present the results of the prospective research conducted in four regional laboratories of the Centre for Medical Microbiology NLZOH between 15 September 2017 and 31 December 2019. We included 110 female patients with suspected acute uncomplicated cystitis who completed a questionnaire and submitted urine samples for microbiological examination.
 Results: The result of urine examination was positive in 79 patients (71.8%). Among all isolates, the most common bacterium was Escherichia coli (74%), followed by Staphylococcus saprophyticus (10%), and others. The susceptibility of E. coli to trimethoprim with sulfamethoxazole was 85.5%, to nitrofurantoin 98.4%, and to fosfomycin 100%. S. saprophyticus isolates were susceptible to the tested antibiotics except for fosfomycin, against which the bacterium is intrinsically resistant. The total susceptibility of all isolates was 85.8% - 88.2% for trimethoprim with sulfamethoxazole, 88.1% - 95.2% for nitrofurantoin, 73.8% - 80.8% for fosfomycin, 72.6% for ampicillin and amoxicillin, 97.7% for cefadroxil, and 98.9% for amoxicillin with clavulanate acid. A comparison with the results of monitoring bacterial resistance as part of the regular work of microbiological laboratories shows significant differences for most of the tested antibiotics.
 Conclusion: The research results show a relatively good susceptibility of the causative agents of acute uncomplicated cystitis to oral antibiotics, the only exception being amoxicillin.

Antibiotic Resistance Patterns Among Uropathogens in Female Outpatients Affected by Uncomplicated Cystitis: Focus on Fosfomycin Trometamol

To report the resistance rate against fosfomycin trometamol among outpatient women with symptoms related to UTI during a 6 years-period in a multicentre cross-sectional study. Urinary samples were collected from three high volume laboratories from January 2015 to December 2020. The pattern of resistance to fosfomycin was analysed by using the Vitek II automated system. During the study period 7,289 urinary samples were collected and 8,321 strains were analysed. Escherichia coli was the most common isolated uropathogens (n=6,583, 79.1%). The mean resistance rate against fosfomycin was 9.7% (ranging from 7.1 to 11.3). No statistically significant difference was found between the three laboratories (p=0.53). There was no significant increase in resistance rate during the study period. The mean resistance rate against fosfomycin was higher among ESBL-producing bacteria when compared with no ESBL-producing strains (10.8% vs 7.9%, p<0.001). Uropathogens isolated from women affected by cystitis remained highly susceptible to fosfomycin. Our findings confirm recommendations in international guidelines that advocate fosfomycin trometamol for empirical treatment of uncomplicated cystitis in women.

Обезболивающий и антидизурический эффекты феназопиридина в лечении острого неосложненного цистита: результаты 3-летнего исследования.

Introduction. Currently, there is a renaissance of phenazopyridine in world urology. The aim of this work was to study the analgesic and antidysuric effects of phenazopyridine, as well as to evaluate the efficacy and tolerability of phenazopyridine in combination with fosfomycin for the treatment of acute uncomplicated cystitis in women of working age. Materials and methods. In 2020–2022 a multicenter randomized open study was conducted. This study involved 224 women aged 18 to 60 years with acute uncomplicated cystitis. They were randomized into two groups of 112 people each. In the first group, patients received oral phenazopyridine (Urinalgin F, earlier Fenazalgin) 200 mg 3 times a day for 2 days (total dose 1200 mg) and fosfomycin trometamol (Monural) at a dose of 3 g once. In the 2nd group, women received orally once 3 g of fosfomycin trometamol and drotaverine hydrochloride (No-spa) 80 mg 3 times a day for 2 days. The visual analogue scale (VAS) of pain, the assessment of symptoms of cystitis according to the ACSS scale, urinalysis by microscopy, and bacteriological examination of urine were used. The results were evaluated after 6, 12, 24 and 48 hours, 3 and 6 days. Results. In the 1st group, a strong uroanalgesic and antidysuric effect of phenazopyridine was revealed. According to VAS, the severity of pain decreased from the initial 7.3±0.5 points after 6 hours to 3.7±0.4 points, after 12 hours to 1.6 points, after 24 hours to 0.4 points, and after 48 hours the pain disappeared in all 112 patients. The sum of the characteristic symptoms of cystitis on the ACSS scale from the initial 12.2±0.5 points decreased to 2.1±0.2 points after 3 days, and to 0.27±0.04 points after 6 days. In patients of the 2nd group, for all indicators, a less pronounced symptomatic effect was obtained with relief of pain and dysuria. The combined treatment of cystitis with fosfomycin and phenazopyridine turned out to be more effective than the combination of fosfomycin and drotaverine hydrochloride: in the 1st group, 97.3% of patients recovered, bacteriological efficiency was 96.8%, leukocyturia disappeared at an earlier date, by 30% reduced treatment time. An undesirable effect of phenazopyridine (nausea) was detected in 1 (0.9%) patient. Сonclusion. Phenazopyridine has a pronounced uroanalgesic and antidysuric effect and is an effective and safe agent for the symptomatic treatment of patients with acute uncomplicated cystitis. The combination of the antibiotic fosfomycin and the uroanalgesic phenazopyridine improves the results of the treatment of acute uncomplicated cystitis, has a clinical efficacy of 97.3% and a bacteriological efficacy of 96.8%.

JMM Profile: Fosfomycin: a potential antibiotic for multi- and extensively resistant bacteria.

Fosfomycin (FOF) is the first antimicrobial of the epoxide class. It is commercially available in oral and parenteral formulations. Oral FOF is widely used to treat uncomplicated cystitis in women, while parenteral FOF is extensively utilized for upper urinary tract infections. FOF has a broad-spectrum bactericidal activity with a low risk of cross-resistance to other antimicrobial classes. Therefore, parenteral FOF is increasingly prescribed adjunctive therapy to treat extra-urinary tract infections caused by multidrug-resistant, Gram-negative bacteria.

Urinarne infekcije - savremeni pristup dijagnostici i lečenju

Urinary tract infections are among the most common infections in the human population. Inadequate interpretation of laboratory findings, as well as mistakes in the application of therapy, often lead to prolongation of treatment and recurrence of infections as well as in a bacterial resistance. The analysis and synthesis of relevant information on up-to-date recommendations in the diagnosis and treatment of urinary infections have been done by searching databases of PubMed, Google academic, Medline and the guidelines of the European Association of Urology, an analysis and synthesis of relevant information on up-to-date recommendations in the diagnosis and treatment of urinary infections will be done. Relevant guidelines recommend usage of Fosfomycin, Nitrofurantoin or Trimethoprim Sulfomethoxazole as the first line of therapy for uncomplicated cystitis in women, while the use of antibiotics in asymptomatic bacteriuria is reserved only for immunocompromised conditions, pregnancy, in patients with chronic recurrent infections and in patients undergoing endourological procedures. Following the modern guidelines of the European Association of Urologists on the treatment of urinary infections enables the most adequate treatment of patients.

Xyloglucan, Hibiscus and Propolis in the Management of Uncomplicated Lower Urinary Tract Infections: A Systematic Review and Meta-Analysis.

Background: In the era of antibiotic resistance, an antibiotic-sparing approach presents an interesting alternative treatment of uncomplicated cystitis in women. Our aim is to perform a systematic review and meta-analysis to compare the effectiveness and safety profile of a medical device containing xyloglucan, hibiscus and propolis (XHP) in women with uncomplicated cystitis. Methods: Relevant databases were searched using methods recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The primary endpoint was clinical or microbiological success, defined as the complete (cure) and/or non-complete (improvement) resolution of symptoms at the end of treatment, or microbiological resolutions. Results: After screening 21 articles, three studies were included, recruiting a total of 178 patients. All three studies used placebo as comparator. A statistically significant difference was found in terms of clinical or microbiological resolution between the medical device and the comparator (3 RCTs, 178 patients, OR: 0.13; 95% CI: 0.05–0.33; p < 0.0001). No clinically significant adverse effects have been reported. Conclusion: A medical device containing xyloglucan, hibiscus and propolis is superior to comparator regimens in terms of clinical effectiveness in adult women with microbiologically confirmed or clinical suspicion of uncomplicated cystitis and is associated with a high patient compliance.

The Effect of Sociodemographic Factors, Parity and Cervical Cancer on Antibiotic Treatment for Uncomplicated Cystitis in Women: A Nationwide Cohort Study.

Background: Uncomplicated cystitis is one of the most common reasons for antibiotic treatment in otherwise healthy women. Nationwide studies on antibiotic treatment for this infection and in relation to factors beyond the infection itself have hitherto not been available. Methods: This was a nationwide open cohort study consisting of 352,507 women aged 15–50 years with uncomplicated cystitis (2006–2018). The outcome was a redeemed antibiotic prescription within five days from the cystitis diagnosis. Logistic regression models were used to examine the relationship between the outcome and the predictor variables. Results: This study identified 192,065 redeemed treatments (54.5%). Several sociodemographic variables were associated with antibiotic treatment. For example, women with the lowest income had an odds ratio (OR) of 1.26 (95% CI 1.23–1.28) compared to those with the highest income. History of cervical cancer and high parity were also associated with lower treatment rates. Conclusion: This study presents novel factors beyond the infection which seem to affect the antibiotic treatment for uncomplicated cystitis in women. Future studies to investigate possible mechanisms are warranted in order to properly use our findings. This may help healthcare workers and planners to provide a more equal treatment plan for this common infection, which may reduce misuse of antibiotics, decrease costs and improve efforts against antibiotic resistance.

Sociodemographic factors and uncomplicated cystitis in women aged 15-50 years: a nationwide Swedish cohort registry study (1997-2018).

BackgroundSymptoms suggestive of uncomplicated cystitis constitutes one of the most common reasons to seek health care in otherwise healthy women. Previous studies regarding the relationship between sociodemographic factors and uncomplicated cystitis are limited, mainly because of the lack of nationwide population-based data from primary healthcare settings, where most uncomplicated cystitis are diagnosed.MethodsA Swedish nation-wide open cohort study consisting of 2 044 065 females who were 15–50 years of age during the study period (1997–2018) was conducted. The outcome was first event uncomplicated cystitis diagnosed in primary health care rather than an assessment of the "true" incidence, which is not feasible in nationwide datasets. Cox regression models were used in the statistical analyses.FindingsThe study identified 546 076 first events of uncomplicated cystitis (26•7% of the study population), corresponding to an incidence rate per 100 person-years of 2•91 (95% CI 2•90–2•91). In fully adjusted models, rural living was associated with lower risks of uncomplicated cystitis (Hazard ratio, HR, 0•67; 95% CI, 0•66–0•68) compared to urban living, while both Middle Eastern/North African (HR, 1•15; 95% CI, 1•14–1•16) and Latin American/Caribbean (HR, 1•24; 95% CI, 1•22–1•27) women had higher risks compared to Swedish women. Low education and low income were also associated with higher risks compared to high education and high income.InterpretationThis study presents novel risk factors associated with uncomplicated cystitis in women. The findings may help health care workers in the treatment of women with symptoms of uncomplicated cystitis.FundingThe Primary Healthcare Management and ALF funding (Region Skåne, Sweden) and the Swedish Research Council.

War and Peace: the difficult treatment of urinary tract infections and fosfomycin trometamol

The title of this review “War and peace” is not accidental and the analogies with a well-known literary masterpiece have absolutely justified ground. As in the case of Lev Tolstoy’s novel this title has a profound philosophical meaning, although at first glance it may seem quite obvious. The word «war» may well correspond to those hostile changes of microorganisms leading to the current problem of antimicrobial resistance recognized worldwide. This is the “war” we have to wage against the antibiotic-resistant bacteria today. And the «peace» in this context is considered as the world, the entire universe, all people, the whole society and its reaction to what is happening. On the other hand, the word «peace» means something opposite in meaning to the word «war». Thus, the essence of the title bears a sharp contrast between military actions and peacetime, between something that carries a threat to life and peace, or illness and recovery. Preserving original novel’s structure the authors of this review consistently consider justification of fosfomycin trometamol as a first-line drug in the treatment of acute uncomplicated cystitis in women taking into account the latest research, publications and global trends.

Some aspects of use of fosfomycin in treatment of postcoital cystitis in practice of a dermatovenerologist

Objective — to develop an algorithm for managing patients with postcoital and uncomplicated cystitis.Materials and methods. The algorithm for the management of a patient with uncomplicated cystitis, according to the guidelines of the European Association of Urology, includes the following steps: the clinical diagnosis with a high probabi­lity can be established based on symptoms of the lower urinary tract, such as dysuria (impaired urination), frequent painful urination, peremptory urge, pain, poor health, if there is no vaginal discharge or irritation. Under our supervision there was a group of 15 women with postcoital cystitis, and 10 women with uncomplicated cystitis of a bacterial nature aged 21 to 48 years, who underwent outpatient treatment at Kyiv City Dermatovenerologic Hospital and other clinical facilities of the Department of Dermatovenerology.Results and discussion. Clinical observation results showed that a single use of phosphomycin (Phosphomed) in postcoital and uncomplicated cystitis in women has an antimicrobial and anti-inflammatory effect, reduces the clinical manifestations of the disease, in particular, the frequency of urination, discomfort and significantly improves the quality of life of patients. Side effects after use were not observed. Positive dynamics was observed starting from the 2nd hour after the use of the drug in all patients, clinical recovery was observed 12 hours after taking the drug.Conclusions. It was determined that a single use of Phosphomed in postcoital and uncomplicated cystitis in women has an antimicrobial and anti-inflammatory effect, reduces the clinical manifestations of the disease, in particular, reduces the frequency of urination, discomfort and significantly improves the quality of life of patients. The observation results make it possible to recommend Phosphomed as the drug of choice for patients with postcoital and uncomplicated cystitis, even for a single use, as also for preventing the occurrence of relapses.

Опыт применения фосфомицина в терапии острого неосложненного цистита у женщин в послеродовом периоде

To determine whether fosfomycin can be used in treatment of women with acute uncomplicated cystitis in the postpartum period. The results of treatment of acute uncomplicated cystitis in 51 patients in the postpartum period were retrospectively evaluated. All patients received a single dose 3 g of fosfomycin. In order to determine clinical efficiency, in all cases laboratory tests were performed prior to and 3 days after treatment. A degree of pain syndrome, the number of voids and urgent episodes were also evaluated. Urine culture was studied before and 7 days after taking fosfomycin. There was a decrease in the number of leukocytes and erythrocytes in urine, number of voids, including urgent episodes. A normalization of urine flora after a single dose of the fosfomycin was noted. In our research in the repeated analysis of urine culture, the number of bacteria was lower than 104 in all cases, and there was also decrease in the number of voids and intensity of pain syndrome. The treatment of acute uncomplicated cystitis in women in the early postpartum period has its own characteristics. A single dose of fosfomycin allows to avoid long-term use of the antibiotic and to continue breastfeeding, which is required for the treatment of this disease in lactating women. One of the medicine used in AAC is Fosfomycin Esparma, which has a high safety profile. The use of high-quality antibacterial therapy in these patients to give possibility to avoid complications.

Comparative Assessment of Canephron® N and Ciprofloxacin as Monotherapy of Acute Uncomplicated Cystitis in Women

The objective: to compare the efficacy and safety of Canephron® N and ciprofloxacin as monotherapy in the management of mild forms of acute uncomplicated cystitis in women of working age.Materials and methods. A prospective, randomized study of Canephron® N and ciprofloxacin for treating mild forms of acute uncomplicated cystitis (ACSS score &lt;10) comprising 160 women aged 18-55 years was conducted from 2015 to 2017. Group I consisted of 80 women, who received oral Canephron® N 2 tablets 3 times daily for 30 days. Group II included 80 women who took oral ciprofloxacin0.5 g twice daily for 3 days. The results were assessed using the ACSS scale, urinalysis by microscopy, bacteriological examination ofurine, etc. The outcomes were evaluated at 3, 6 and 30 days, and one year after the treatment initiation.Results. In group I, monotherapy with Canephron® N resulted in a marked improvement in symptoms, a decrease in the ACSS scores from 7.9 at baseline to 0.1 at day 30. The indicator of clinical efficacy (recovery) was 93.75%, bacteriological efficiency was 91.3%, relapse of cystitis within one year was observed in 5% of patients; no side effects were registered. In group II, the symptoms and bacteriuria decreased more rapidly in the early periods, but after 30 days the results of clinical and bacteriological efficacy did not differ from the group I (93.75 and 91.3%, respectively). Side effects and cystitis relapses were noted in 18.8% and 12.5% of patients, respectively.Conclusion. The findings of the study show that Canephron® N is an effective and safe alternative to treating mild forms (ACSS score &lt;10) of acute uncomplicated cystitis in women, allowing the use of antibiotics to be reduced. In our opinion, patients with more severe forms of acute uncomplicated cystitis should be treated with traditional antibiotic therapy.

Evaluation of the draft guidelines proposed by EMA and FDA for the clinical diagnosis of acute uncomplicated cystitis in women

PurposeTo reassess the diagnostic values of the “draft” guidelines for the clinical diagnosis of acute uncomplicated cystitis (AC), recently proposed by US Food and Drug Administration (FDA) and European Medicines Agency (EMA).MethodsThe data of 517 female respondents (patients with acute cystitis and controls) derived from the e-USQOLAT database were analyzed and used for the validation of proposed “draft” guidelines of FDA and EMA, compared to the Acute Cystitis Symptom Score (ACSS) questionnaire. The diagnostic values of the proposals concerning signs, symptoms and their severity were assessed and compared.ResultsThe six “typical” symptoms of the ACSS were strongly associated with the diagnosis of AC. The number of positive “typical” symptoms differed significantly between patients and controls: median 5 (IQR 4–6) vs 1 (IQR 0–3) respectively. Scored severity of “typical” symptoms also differed significantly between groups of patients and controls: median (IQR) 10 (7–13) vs 1 (0–4), respectively. The best balance between sensitivity and specificity is shown by the ACSS cut-off value of 6 scores and more of the “Typical” domain, followed by an approach proposed by FDA and EMA, justifying ACSS to be used as a diagnostic criterion for the clinical diagnosis of AC.ConclusionsNot only the presence but also the severity of the symptoms is important for an accurate diagnosis of AC. The ACSS, even without urinalysis is at least as favourable as the draft diagnostic proposals by FDA and EMA. The ACSS can be recommended for epidemiological and interventional studies, and allows women to establish self-diagnosis of AC, making the ACSS also cost-effective for healthcare.

28 - Evaluation of the proposed update of FDA guidelines on the symptomatic diagnosis of acute uncomplicated cystitis in women

28 - Evaluation of the proposed update of FDA guidelines on the symptomatic diagnosis of acute uncomplicated cystitis in women

Green tea as an adjunctive therapy for treatment of acute uncomplicated cystitis in women: A randomized clinical trial

Backgroundand purpose: Different in vitro studies have reported the antimicrobial effects of green tea catechins and also their synergistic effects with trimethoprim–sulfamethoxazole against E. coli. The aim of the present study was to evaluate the efficacy of green tea as an adjunctive therapy to standard antimicrobial treatment in women with acute uncomplicated cystitis. Materials and methodsIn this blinded randomized trial, 70 patients were assigned to receive four 500 mg capsules of green tea or starch as placebo daily for three days along with trimethoprim–sulfamethoxazole. The presence of acute uncomplicated cystitis symptoms was recorded and urinalysis was performed. ResultsWomen in the green tea group showed a statistically significant decrease in the prevalence of cystitis symptoms and a statistically significant improvement in the urinalysis results except for hematuria after 3 days of treatment. ConclusionGreen tea was an effective adjunct to trimethoprim–sulfamethoxazole to treat acute uncomplicated cystitis in women.

Сравнительная оценка монотерапии препаратами Канефрон Н и ципрофлоксацин острого неосложненного цистита у женщин

A prospective, randomized study of Canephron N and ciprofloxacin for treating mild forms of acute uncomplicated cystitis (ACSS score less or equal 10) comprising 160 women aged 18-55 years was conducted from 2015 to 2017. Group I consisted of 80 women, who received oral Canephron N 2 tablets 3 times daily for 30 days. Group II included 80 women who took oral ciprofloxacin 0.5 g twice daily for 3 days. The results were assessed using the ACSS scale, urinalysis by microscopy, bacteriological examination of urine, etc. The outcomes were evaluated at 3, 6 and 30 days, and one year after the treatment initiation. In group I, monotherapy with Canephron NH resulted in a marked improvement in symptoms, a decrease in the ACSS scores from 7.9 at baseline to 0.1 at day 30. The indicator of clinical efficacy (recovery) was 93.75%, bacteriological efficiency was 91.3%, relapse of cystitis within one year was observed in 5% of patients; no side effects were registered. In group II, the symptoms and bacteriuria decreased more rapidly in the early periods, but after 30 days the results of clinical and bacteriological efficacy did not differ from the group I (93.75 and 91.3%, respectively). Side effects and cystitis relapses were noted in 18.8% and 12.5% of patients, respectively. The findings of the study show that Canephron N is an effective and safe alternative to treating mild forms (ACSS score less or equal 10) of acute uncomplicated cystitis in women, allowing the use of antibiotics to be reduced. In our opinion, patients with more severe forms of acute uncomplicated cystitis should be treated with traditional antibiotic therapy.

Acute uncomplicated cystitis: is antibiotic unavoidable?

Acute uncomplicated cystitis in women is one of the most frequently diagnosed bacterial infections. In a pilot, open, noncomparative prospective study, 29 nonpregnant, sexually active women with acute uncomplicated cystitis were enrolled. The mean age was 28.9 ± 4.3, range 22-36 years. All patients received unique therapy: the nonsteroidal anti-inflammatory drug (NSAID) ketoprofen, 100 mg once a day for 5 days, and Canephron, 2 dragees three times a day for 1 month. In 2 days, four patients (13.8%) had no tendency to improvement; they were considered as nonresponders and antibiotics were prescribed for them. The remaining 25 patients (86.2%) showed significant improvement and were considered as responders; they continued the therapy with ketoprofen and Canephron. In 7 days, 21 patients (72.4%) had no dysuria and leucocyturia; they were considered as fast responders to phytotherapy. In four patients (13.8%), after 7 days of therapy insignificant dysuria and leucocyturia were found; they were considered as slow responders to phytotherapy. All 25 patients continued the intake of Canephron for 1 month to prevent a relapse. When treatment finished, all patients were well. In 6 months, no relapses were diagnosed. The majority (86.2%) of young, nonpregnant women with acute uncomplicated cystitis were cured by 30 days of phytotherapy combined initially (5 days) with the NSAID ketoprofen; an antibiotic was indicated in only 13.8% of patients. Patients with acute uncomplicated cystitis may be divided into three subgroup: nonresponders to phytotherapy; slow responders to phytotherapy; fast responders to phytotherapy. Antibiotic therapy is indicated in nonresponders, but slow and fast responders may be treated without an antibiotic, by phytotherapy with an initial short course of an NSAID only.

Use of Canephron® N in treatment of acute uncomplicated cystitis in women

Use of Canephron® N in treatment of acute uncomplicated cystitis in women

Use of Canephron® N in treatment of acute uncom plicated cystitis in women

The objective: of study was to evaluate the efficacy and safety of Canephron ® N with uncomplicated cystitis in women in clinical practice.Patients and methods. In our work was attended by 22 women with a diagnosis of acute uncomplicated cystitis. The mean age was 29,0±1,8 years (from 19 to 51 years. The criteria of effectiveness were changes in symptoms and laboratory parameters according to the urinary tests at Canephron ® N monotherapy.Results. After treating by Canephron ® N there were observed significant improvement in symptoms of acute cystitis. Before treatment the average symptom score was 8,05±0,7 points, on the 3rd day of treatment it significantly decreased to 5,1±1,0 points (p&lt;0,05) on day 7 of treatment it was up to 2,9±1,0 points, in the phase of observation of 37 days after initiation of therapy by Canephron ® N othe average score of symptoms was 0,1±0,3 points. Frequency leukocyturia on the 7 day of treatment according to a study by urine microscopy was 83,3%, and by the 37-th day after the start of Canephron ® N (phase monitoring) significantly decreased to 37,5% (p&lt;0,05). Canephron ® N showed statistically significant antibacterial activity in acute cystitis. Prior to initiating therapy the growth of microorganisms at a titer of more than 100 000 units was detected in 72,7% of patients after 2 weeks of treatment (on day 37 of observation) – in 28,6% of patients (p&lt;0,05). Conclusions. Our results suggest that Canephron ® N can be an effective and well tolerated alternative treatment of uncomplicated infections of the lower urinary tract in women, allowing to reduce the use of antibiotics. Appointment of the drug as a monotherapy Canephron ® N acute cystitis and duration of treatment requires further study and discussion