Pilot study of sequential oral antibiotics for the treatment of interstitial cystitis

John W. Warren, Linda M. Horne, J. Richard Hebel, Richard P. Marvel, Susan K. Keay, Toby C. Chai

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Purpose: 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. Materials and 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.

Original languageEnglish (US)
Pages (from-to)1685-1688
Number of pages4
JournalJournal of Urology
Issue number6
StatePublished - Jun 2000


  • Antibiotics
  • Bladder
  • Cystitis
  • Interstitial
  • Urination disorder

ASJC Scopus subject areas

  • Urology


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