Cystitis Research Center

- Study to Evaluate Antibiotic Treatment for IC -

by Ruth Kriz, R.N. & Anne Peck

In 1990. the CA awarded a pilot research grant to Ruth Kriz, R.N., M.S.N., C.P.N.P. and Anne W. Peck for their project "The Evaluation of Antibiotic Therapy Recommended by Dr. Paul Fugazzotto for the Treatment of IC.' Ms. Kriz is CA State Coordinator for Virginia. Below are the results of her study.

Ms. Kriz undertook this study to evaluate the efficacy of long-term antibiotic therapy in the treatment of IC based on the findings of South Dakota microbiologist. Paul Fugazzotto, Ph.D. For five years, Dr. Fugazzotto, using a washing procedure and broth culture media has reported culturing gram positive bacteria (primarily enterococcus and gaffkya) in the urine of over 95% of IC patients he has examined. It is the belief of Dr. Fugazzotto that IC is caused

In the Kriz/Peck study, 100 patients were surveyed whom reported positive urine cultures from Dr. Fugazzotto's laboratory. Analysis was based on 62 Patients who had tried antibiotics ranging from 2-14 months. The 62 respondents were divided into 3 groups:

IC diagnosis confirmed by a physician based on NIH.
IC diagnosis suspected but test results either not obtained or inconclusive. (9 patients)
Positive IC diagnosis reported by patient but physician did not respond to letter requesting confirmation. (15 patients)

Of the 3 groups statistical analysis revealed no differences between the groups on any of the variables.

Two rating scales were used. One rated frequency of symptoms ranging from "never" to "daily". The second scale rated severity of symptoms including pain, pressure, urgency, and frequency and burning. This scale ranged from "no discomfort at all" to "very severe discomfort." The severity and frequency of symptoms were then graphed for (1) the time before antibiotics were administered (2) while the antibiotics were administered and (3) after the antibiotic were discontinued. The graphs below illustrate the marked improvement in severity and frequency of symptoms while antibiotics were taken and after they were discontinued these graphs represent an average improvement. Some patients had slight improvement while others experienced dramatic improvement of their IC symptom.

Out of 16 respondents who reported duration, the average time on antibiotics was 5.7 weeks. Thirty-four stopped the medication; 26 were continuing at the time of the survey. Those continuing reported even further improvement in their symptoms than the 34 who stopped. Reasons for discontinuing antibiotics included side effects (17), doctor recommended (14), no improvement (13) and other reasons (4).

Seventy-nine percent of IC patients surveyed reported the use of long term antibiotics improved their symptoms. Statistically significant differences were found in severity of symptoms and their frequency both during and after antibiotics were taken when compared with prior symptoms. Those who continued on the antibiotics reported greater improvement than those who stopped.

While these preliminary results appear promising, it is important to note that a larger sample size and a double-blind placebo clinical trial would be necessary to further substantiate these findings. If you are considering trying antibiotic theory it is important that you consult you physician. In addition, patients on antibiotics need information on bowel bacteria replacement, which may prevent diarrhea as well as ways of preventing yeast.