Purpose: Although women commonly experience acute cystitis, the impact of this infection and its treatment on quality of life (QOL) has not been described. The purpose of this study was to measure the effects of acute cystitis and antibiotic treatment on QOL.

Methods: One-hundred-fifty-seven women with clinical signs and symptoms of acute uncomplicated cystitis were recruited at two family medicine outpatient clinics. Patients were randomized to receive TMP/SMX for 3 days, ciprofloxacin for 3 days, or nitrofurantoin for 7 days as treatment for their infections. QOL was measured using the Quality of Well-Being scale, a validated multi-attribute single-day instrument, in which 1 represents perfect health and zero, death. Follow-up telephone contacts were completed at 3, 7, 14 and 28 days after the initial visit. QOL, clinical outcomes, and adverse events were assessed during these interviews.

Results: The mean QOL score improved for all patients, from a mean (± SD) of 0.68 (± 0.03) at baseline to 0.81 (± 0.11) at day 28. Patients experiencing a clinical cure with the initial course of antibiotics had significantly better QOL at Day 3 (p=0.04), Day 7 (p<0.001), and Day 14 (p=0.01) compared to patients who failed their initial antibiotic treatments. Clinical cure rates for the three different antibiotic regimens were similar (p=0.7) and there was no difference in QOL by treatment assignment at any of the follow-up times (p>0.05 for each). However, patients experiencing any adverse event had significantly lower QOL on Day 3 (p=0.001) and Day 7 (p<0.001) than subjects who did not report adverse events.

Conclusions: Women experiencing acute cystitis have measurable gain in QOL in conjunction with treatment of these infections. However, experiencing any adverse event from treatment has a negative impact on this trend during the first week of treatment as does treatment failure. As measured by the Quality of Well-Being scale, we did not find a significant difference between the 3 antibiotic treatments.