Urinary tract infection
From Ganfyd
The term urinary tract infection is a general term that does not indicate either the specific location or severity of the infection. It can cover a range of infections, from uncomplicated, self-limiting cystitis to life-threatening, systemic urosepsis. In common parlance, it often refers to uncomplicated cystitis and urethritis, but for clarity it is helpful to be more specific about the location and the context of an UTI.
Contents |
Signs and Symptoms
Depends on location.
Uncomplicated UTIs in women can be best predicted from:[1]
- Dysuria
- Frequency
- Back pain
- Haematuria
- Costovertebral angle (i.e. renal angle) tenderness
UTI in Children
Common causes:
- Vesicoureteral reflux
- Congenital hydronephrosis
Prophylaxis
You need to treat 14 (95% CI 9-86) children with low dose co-trimoxazole to prevent one recurrent UTI[2]. You might also reduce other bacterial infections (eg respiratory tract) at the cost of using an antibiotic combination that is depreciated due to risk of agranulocytosis and rash.
UTI in Males
Recurrent UTI in Women
Post-intercourse cystitis
Some women get cystitis frequently after intercourse. This may vary according to partner. This may sometimes be mechanical, but is often a UTI, in which case it is most often E Coli or other organisms from the GI tract.
Post-intercourse antibiotic prophylaxis for women in whom infections are associated with sexual intercourse has type 1bA evidence of effectiveness[1]. Pragmatically, taking a single dose of an antibiotic in anticipation of intercourse may be less prone to forgetfulness.
 | Multiple studies of voiding before or after intercourse, nor of front to back wiping, bath oils, or cotton underwear have not provided evidence of effectiveness. |
Acidification, cranberry juice and probiotics are helpful
Treatment
This article is a stub. Please feel free to expand it and make it more encyclopaedic.
References
- ↑ Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S. Does this woman have an acute uncomplicated urinary tract infection? JAMA. 2002 May 22-29;287(20):2701-10. Review. (Direct link - requires registration)
- ↑ Craig JC, Simpson JM, Williams GJ, Lowe A, Reynolds GJ, McTaggart SJ, Hodson EM, Carapetis JR, Cranswick NE, Smith G, Irwig LM, Caldwell PH, Hamilton S, Roy LP. Antibiotic prophylaxis and recurrent urinary tract infection in children. The New England journal of medicine. 2009 Oct 29; 361(18):1748-59.(Link to article – subscription may be required.)
