Approximately 25% of individuals who suffer a bladder infection will suffer a recurrence. A course of antibiotics usually clears up the infection; however, not uncommonly, it will flare up again. A new study has found why this happens and notes that the addition of chitosan to the antibiotic therapy may prevent a recurrence. It also notes the most effective antibiotics for treatment. The findings were published on March 25 in the journal PLOS ONE by researchers at the University of Utah (Salt Lake City, Utah) and the University of Ljubljana (Ljublijana, Slovenia).
The researchers note that many bladder infections are caused by the bacterium Escherichia coli, which seed the cells lining the bladder. Reservoirs of these bacteria exist within the cells and are resistant to antibiotics. As a result, a recurrence occurs. In their search for a solution to this problem, the investigators tested a number of antibiotics with chitosan, which is a derivative found shellfish that has been used as a drug carrier. The studies were conducted in mouse models. They found that a class of antibiotics known as fluoroquinolones, including the commonly prescribed sparfloxacin (Zagam) and ciprofloxacin (Cipro), were the most effective at eliminating the bacteria in the bladder. Chitosan works by causing exfoliation (shedding) of the infected bladder cells. These e cells, which protect urine from entering the bladder tissues, regenerate quickly and reform a protective barrier after the treatment.
The investigators are hopeful that their research will influence how bladder infections are treated in the future. They note that chitosan will be reserved for individuals with recurrent or stubborn infections. Chitosan will most likely be administered directly to the bladder via a catheter.
Bladder infections are much more common in women than men; this is probably do the shorter urethra (tube between the bladder and the urinary outlet). According to the National Kidney Foundation, bladder infections result in almost 10 million doctor visits each year. One in five women will have at least one bladder infection in her lifetime, and approximately 20% will suffer a recurrence. In addition, 80% of the women who suffer a recurrence will have another recurrence. Bacteria responsible for bladder infections are known to survive for long periods of times; thus, causing numerous flare-ups. E. coli, a common cause of bladder infections is present in the lower intestinal tract. Thus, poor hygiene can increase infection risk. After a bowel movement, women should wipe from the front of the anus towards the back. Wiping in the other direction can result in contamination of the urethra.