Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more


  • Comment



VOL: 99, ISSUE: 21, PAGE NO: 29






- Urinary tract infection (UTI) is the occurrence of pathogenic micro-organisms in the urine, urethra, bladder, or kidney. Lower UTI refers to urethritis and/or cystitis.



- Most often caused by a single bacterial pathogen ascending through the urethra to the bladder. From here bacteria may reach the kidney to cause pyelonephritis, although in a minority of cases bacteria may reach the kidney via the bloodstream.






- About five per cent of women each year present to their GP with frequency and dysuria.



- Up to 50 per cent of women will have a symptomatic UTI during their lifetime (Drug and Therapeutics Bulletin, 1998).



- Urethral syndrome: about 50 per cent of women who present with urinary symptoms do not have bacteriuria (Brumfitt et al, 1998).






- Sexual intercourse.



- Atrophic urethritis and vaginitis (in postmenopausal women).



- Abnormalities of urinary tract function (indwelling catheter, neuropathic bladder, vesico-ureteric reflux, outflow obstruction, anatomical abnormalities).



- Incomplete bladder emptying (dysfunctional urination, chronic indwelling catheter).



- Female diaphragm, spermicide-coated condoms.



- Previous urinary tract surgery.



- Immunocompromise.



- Diabetes.



- Renal stones.



- Insufficient fluid intake.






- Urgency - the overwhelming need to pass urine.



- Frequency - the need to pass urine very often.



- Dysuria - pain or a burning sensation on passing urine, or difficulty in passing urine.



- Pyuria - the presence of pus in the urine. The urine may be cloudy.



- Haematuria - presence of blood.



- UTIs can ascend above the bladder to cause pyelonephritis. Symptoms are similar to those of lower UTIs, but also include pyrexia and loin pain.



- Suprapubic discomfort.



- Atypical presentations of cystitis may occur in older people and include secondary incontinence, confusion, anorexia, high temperature, or shock.



- Foul-smelling urine.






- Urine dipstick.



- Urine microscopy.



- Urine culture.



- Imaging and functional tests (not routinely indicated).






- Symptomatic treatment - paracetamol or ibuprofen to relieve pain and high temperature (for approximately one to two days.) A temperature of more than 38.5°C is more characteristic of pyelonephritis.



- Urine-alkalinising agents, such as potassium citrate, sodium citrate, and sodium bicarbonate are popular remedies, however, their efficacy is doubted (Brumfitt et al, 1990).



- Antimicrobial treatment - adhere to local policies and be guided by local patterns of bacterial resistance.



- Frequently used - trimethoprim, nitrofurantoin, cefalexin



- Other antimicrobials: amoxicillin, co-amoxiclav, quinolones, and pivmecillinam. For healthy women with a UTI and who are not pregnant: three days of antimicrobial treatment is as effective as five or seven days. Longer treatment results in greater bacterial resistance.






  • Comment

Related files

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.