title: Pilot study of sequential oral antibiotics for the treatment of interstitial cystitis.
abstract: OBJECTIVE
  Interstitial cystitis is a chronic disease of unknown etiology characterized by bladder pain, urgency and frequency. Although a single microbe has not been implicated as a cause of interstitial cystitis, several groups noted various organisms in the urine of some women with interstitial cystitis and some patients reported that antibiotics decrease symptoms. Consequently we performed a prospective, randomized, double-blinded, placebo controlled pilot study of sequential oral antibiotics.
  
  
  METHODS
  We randomized 50 patients with interstitial cystitis to receive 18 weeks of placebo or antibiotics, including rifampin plus a sequence of doxycycline, erythromycin, metronidazole, clindamycin, amoxicillin and ciprofloxacin for 3 weeks each.
  
  
  RESULTS
  Intent to treat analysis demonstrated that 12 of 25 patients (48%) in the antibiotic and 6 of 25 (24%) in the placebo group reported overall improvement (p = 0.14), while 10 and 5, respectively, noticed improvement in pain and urgency (p = 0.22). In the antibiotic group 20 participants (80%) had adverse effects compared with 10 (40%) in the placebo group (p = 0.009).
  
  
  CONCLUSIONS
  Our findings suggest that these antibiotics alone or in combination may sometimes be associated with decreased symptoms in some patients but they do not represent a major advance in therapy for interstitial cystitis.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Warren
authors.forename: L M
authors.initials: LM
authors.lastname: Horne
authors.forename: J R
authors.initials: JR
authors.lastname: Hebel
authors.forename: R P
authors.initials: RP
authors.lastname: Marvel
authors.forename: S K
authors.initials: SK
authors.lastname: Keay
authors.forename: T C
authors.initials: TC
authors.lastname: Chai
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents; D018856:Cystitis, Interstitial / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents