Identifying cystitis
IDENTIFYING CYSTITIS
You should use considered questions to determine whether your customer has cystitis, an upper UTI, or another condition, as symptoms may present similarly. This will ensure they receive the treatment they need without unnecessary delay. The flashcards below will help you to give appropriate advice and recommendations based on your customers symptoms.
The Pharmacy First service may be considered for women aged 16 to 64 with a suspected lower uncomplicated UTI.4
This service excludes many different groups such as: males, pregnant women, those with a urinary catheter, and those who have had recurrent UTIs (two episodes in past 6 months, or three episodes in past 12 months).4 These customers should be referred to their GP.
Click on the flashcards to learn more about different
gynaecological symptoms and what diagnosis they could indicate
Key symptoms include:4,5
Dysuria - Pain, burning or stinging when urinating
New nocturia – Needing to pass urine at night
Cloudy urine.
Other symptoms of cystitis could include:1,4,5
Increased frequency or urgency to urinate
Urine that's dark or strong smelling
Pain lower down the abdomen
Visible blood in the urine.
When an infection is not limited to the lower urinary tract and has spread upwards towards the kidneys, this can result in a serious infection and symptoms should be assessed urgently by the GP.
Symptoms could include:1,5
Kidney pain/tenderness in back under ribs
New/different muscle pain, flu like illness
Shaking chills (rigors) or fever (37.9°C or above)
Nausea/vomiting
Confusion or drowsiness
Not urinating all day
Blood present in urine.
You should always consider the risk of rapid deterioration or serious illness and consider A&E or calling 999 if there is a risk of sepsis.1
It is important to consider possible alternative conditions so that your customer receives the appropriate care. They may have to be referred to their GP, or a sexual health clinic for appropriate treatment.4
Consider this if your customer has the following:4,5
Vaginal discharge: 80% do not have UTI and may have thrush instead
Sore or inflamed urethra (urethritis): this could be caused by inflammation after sexual intercourse or the effects of irritants such as some toiletries
A sexually transmitted infection (STI): the symptoms can be similar to a UTI
Signs and symptoms of pregnancy – ask about missed or lighter periods
Genitourinary symptoms typical in menopause (thinning and drying of vaginal walls).
Click here to learn more about Managing Menopause
If symptoms worsen rapidly or significantly at any time, or do not improve within 48 hours of taking antibiotics, your customer should be referred to their GP.5 Customers who describe their symptoms as mild and who have not been treated with antibiotics should return and speak to the pharmacist if no improvement is experienced in 48 hours.5