Urinary Tract Infections

Uncomplicated urinary tract infections are infections of the lower urinary tract.

This infection usually affects women of any age who do not have any other health problems, are not pregnant, and do not have any physical problems with their urinary tract.

As it is rather common, it is important to be able to tell the difference between simple UTI (also called cystitis), asymptomatic bacteriuria (increase bacteria count in the urine), and complicated cystitis so that you can choose the right antibiotic and length of treatment.

UTI can be complicated by: being male, immunosuppression, poorly controlled diabetes mellitus, pregnancy, functional or structural abnormality of the urinary tract, recent urological manipulation, nosocomial infections, acute or chronic renal insufficiency, urinary tract obstruction, renal transplant, and catheterized patients or patients who are frequently catheterized.

Typically we do not treat asymptomatic bacteriuria, except in certain groups (e.g., pregnant women, patients undergoing urological procedures).

 

Symptoms of UTI

These usually causes painful urination, frequent urination, pain in the area above the pubic bone, and sometimes blood in the urine. The basics of therapy Given the big differences between regions, if local resistance rates are available, use them to decide which therapy to try first.

Trimethoprim-sulfamethoxazole and nitrofurantoin are first-line treatments that work in 3 and 5 days, respectively.

Fosfomycin is also a first-line treatment, but it may not work as well. It is a top choice because it only needs one dose and very few people are resistant to it.

Both trimethoprim and beta-lactams can be used as first-line treatments.

Beta-lactams are considered alternatives because their effectiveness is less predictable when they are used as a first-line treatment, and the treatment takes longer.

Also, broad-spectrum cephalosporins are more likely to cause bacteria to become resistant to antibiotics and other drugs.

Lastly, susceptibility testing should show that amoxicillin alone is the best choice.

Quinolones work, but they are considered second-line treatments because bacteria are becoming more resistant to them, they are linked to bacteria that are resistant to multiple drugs, and they may hurt tendons. Because of the risk of resistance, agents in this class should not be given again if they have been used in the last 3–6 months, no matter what the reason.

So, it makes sense to only use them as an alternative to first-line drugs or when other treatments have failed. If the treatment does not work after a month, a urine culture should be done and the right treatment should be given.

Analgesics can be recommended as a complementary treatment for up to 48 hours, so that they do not hide any possible signs of a problem.

The same is true for phenazopyridine, an analgesic for the urinary tract. No one knows exactly how it works, but it seems to help. Urinary tract infections that come back often.

A person has a recurrent infection if they get it twice in six months or if they get three positive cultures or infections in one year.

Some things make it more likely that it will happen again. For women before menopause, these include having more sexual partners, using spermicide, having new sexual partners, having had urinary tract infections before age 15, or having a mother who had them.

You can avoid getting urinary tract infections over and over again in three ways: with continuous antimicrobial prophylaxis, post-coital prophylaxis, and self-treatment.

There are different opinions on how well cranberry products work as a preventive measure, so they can not be recommended routinely.