The cost of treatment may be a major part of the decision taken on what antibiotic is used to treat you.

Unfortunately, doctors who do not take cystitis seriously in women, also tend not to treat it properly. But some doctors are great, and will do all the right tests, checking your infection cultures against different combinations of antibiotics to see what is the most effective antibiotic, and what is the lowest dose that is effective against your particular strain of infection.

See also: Antibiotic side-effects

Mohamed H. Dahir - Chairman Pharmaceutical Association of Somaliland, The Dangers of Indomethacin:

"If a bacterium is responsible, it is extremely important for the doctor to know which specific bug is causing the trouble so that he can treat it with the right drug. Using a broad-spectrum antibiotic is a cop-out. It is the lazy way to do medicine, since it allows the doctor to cut out the time necessary to do a proper laboratory work-up and diagnosis."

Others will (perhaps) test for the presence of E.coli, and then prescribe antibiotics without taking previous infections into account. They'll treat each infection as a new infection, instead of as a reinfection, or as a recurrence of the same infection, despite the fact that antibiotics leave 21% of women with vaginal E.coli still present after 6 weeks (see below). So they'll give you the same dosage as last time, and if it's the same bug you were fighting before, that's been living quietly in your urinary tract just waiting for your immune system to go down a bit to allow it to start multiplying again, or for you to have sex and shake some E.coli loose from their protected place underneath their bio shield on your bladder wall, it will take that antibiotic longer to kill the infection, helping the bug to build up resistance.

Read the Drug Watch study for more information. What becomes clear is that rather than testing your particular infection to determine the most appropriate treatment, patients are treated statistically. You are statistically more likely to respond to trimethoprim-sulphamethoxazole, so that is the first antibiotic that most doctors choose - it is also, conveniently, the cheapest antibiotic, and hence the cheapest way for a doctor to attend to your infection. And most of the time they can order the cheapest tests - just testing for the presence of an infection.

Note also that (in the absence of Waterfall D-Mannose™ ):

"Trimethoprim-sulphamethoxazole proved to be the best treatment, with 82% of women cured at the six-week visit, and with the lowest remaining incidence of vaginal E coli (21%). Adverse events were reported by 35% of patients treated with trimethoprim-sulphamethoxazole, similar to other treatments. " Drug Watch

Note the huge number of women (35%) with adverse effects, and compare this to over 90% of infections cleared by Waterfall D-Mannose, and 0% of patients suffering adverse effects. The presence of E.coli after using Waterfall D-Mannose is not known, but what is known is that if you take Waterfall D-Mannose, even after being treated for cystitis with strong antibiotics over an extended period, a huge amount of E.coli is flushed out of your urinary tract. This strongly suggests that many fewer women will be left with E.coli after taking Waterfall D-Mannose

, than after taking antibiotics.