Will One Dose of Medicine Cure a Bladder Infection?

QUESTION: You wrote that you believe in one dose of medicine to cure a
bladder infection. My doctor says you're wrong. Who should I believe?
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ANSWER: This is an area about which there is some obvious disagreement; in
fact, a recent issue of a medical journal featured the question, and had two
doctors address the question, one on the side of one-dose therapy, and one on
the side of several days of therapy for bladder infection. Both sides
presented valid arguments.
The one-dose method has the advantages of reducing the complications of
longer-term therapy, such as stomach upset and yeast vaginitis. Cost is
usually lower and taking one pill is more convenient than taking several a day
for several days. Initial reports about this method of treatment indicated
that cure rates were quite high; now, with more experience with this method,
we are seeing that only about 70 percent of patients are cured using the
one-dose method. In young, healthy people, this is not a significant health
risk; if the problem is not cured, it does not progress to a more serious one
but instead creates uncomfortable symptoms.
Instead of the one-dose method, many doctors are now favoring a
compromise between the one-dose and the longer, more conventional method.
Three days of therapy is effective in most healthy patients, and the cost of
this treatment is comparable to the one-dose cost.
Whether medication is given for one day or for several, it is important
that the correct antibiotic be given. Sometimes the bacteria that causes the
infection is not sensitive to that particular medication, and only a change in
medicine will be effective in curing the infection. In people who have
frequent bladder infections, this can be a common problem because they become
resistant to certain antibiotics. The only way to know for sure whether
bacteria is sensitive to a particular antibiotic is to run a "culture and
sensitivity" test.
Anytime an antibiotic is prescribed, whether for a bladder infection or
any other problem, take all of it as prescribed. Don't stop taking it as soon
as the symptoms disappear, because the bacteria are probably still present.
Once the antibiotics are discontinued, the bacteria will again flourish,
causing symptoms. Taking all the medications will help prevent this from
happening.
If you have frequent bladder infections, you may want to evaluate several
habits that may be a factor. Do you empty your bladder every time you
urinate? Bear down after urinating, to ensure that all the urine is emptied
from your bladder. Do you put off urinating? If it is difficult for you to
get to a bathroom, whether because of your job circumstances, a physical
limitation, or maybe the fact that you're traveling, you may be inviting a
bladder infection. Find a way that you can empty your bladder more
frequently. Do you drink at least eight glasses of water a day? Limit your
intake of soft drinks and drink water instead. In females, after using the
toilet, wipe from front to back. This keeps bacteria away from the urethra,
which leads to the normally sterile bladder.
I still hold with the one-dose school of therapy, but am wise enough to
know that no single treatment works for every patient. I am also smart enough
not to argue with a knowledgeable family physician who has examined the
patient, knows the situation, and has the best interests of his patient at
heart. In this case, your doctor is right.