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Urinary tract infection



Bladder catheterization, female
Bladder catheterization, female
Bladder catheterization, male
Bladder catheterization, male
Female urinary tract
Female urinary tract
Male urinary tract
Male urinary tract
Prevention of cystitis
Prevention of cystitis


Urinary tract infection

Alternative Names:

Bladder infection; Cystitis; UTI
Treatment:

A mild case of cystitis may resolve on its own without treatment. Because of the risk of the infection spreading to the kidneys, however, antibiotics are usually recommended. It is important that you finish the entire course of prescribed antibiotics.



In children, cystitis should be treated promptly with antibiotics to protect their developing kidneys. In the elderly, prompt treatment is recommended due to the greater chances of fatal complications.

Commonly used antibiotics include:

  • Nitrofurantoin
  • Cephalosporins
  • Sulfa drugs (sulfonamides)
  • Amoxicillin
  • Trimethoprim-sulfamethoxazole
  • Doxycycline (should not be used under age 8)
  • Quinolones (should not be used in children)

Most non-elderly adult women only need 3 days of antibiotics. If the infection has spread to one of the kidneys, you may need hospitalization to receive hydration and antibiotics through a vein.

A chronic or recurrent UTI should be treated thoroughly because of the chance of kidney infection. Antibiotics may need to be given for a long period of time (as long as 6 months to 2 years), or stronger antibiotics may be needed than for single, uncomplicated episodes of cystitis.

Use of low-dose antibiotics on a daily basis may be recommended to prevent UTIs if you get frequent infections.

Phenazopyridine hydrochloride (pyridium) may be used to reduce the burning and urgency associated with cystitis. In addition, acidifying medications such a ascorbic acid may be recommended to decrease the concentration of bacteria in the urine.

If an anatomical abnormality is present, surgery to correct the problem may be recommended.


Expectations (prognosis):

Cystitis is uncomfortable, but usually responds well to treatment.


Complications:
  • Chronic or recurrent urinary tract infection -- defined as at least twoinfections in 6 months or at least three in 1 year
  • Complicated UTI
  • Kidney infection

Calling your health care provider:

Call your doctor if you, or your child, have symptoms of a UTI. Call right away if there is fever or chills, back or side pain, or vomiting. These symptoms suggest a possible kidney infection.

Also call if:

  • You have diabetes or are pregnant.
  • There is discharge from the penis or vagina.
  • The penis or vagina is painful, or sexual intercourse is painful.
  • You suspect a child may have been sexually abused.
  • There is blood or pus in the urine.
  • The symptoms come back a short time after treatment with antibiotics.

References:

Walsh, PC, ed. Campbell?s Urology. 8th Ed. Philadelphia, PA: Saunders; 2002.

Marx JA, Hockberger RS, Walls RM, eds. Rosen?s Emergency Medicine: Concepts and Clinical Practice. 5th Ed. St. Louis, MO: Mosby; 2002.




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