Urinary Tract Infection Lower
Cystitis and urethritis, the two forms of lower urinary tract infection (UTI), are nearly 10 times more common in women than in men and affect approximately 10% to 20% of all women at least once. Lower UTI is also a prevalent bacterial disease in children, with girls also most commonly affected.
In men and children, lower UTIs are frequently related to anatomic or physiologic abnormalities and therefore require extremely close evaluation. UTIs often respond readily to treatment, but recurrence and resistant bacterial flare-up during therapy are possible.
Normal urine is sterile and contains fluids, salts, and waste products. It is free of bacteria, viruses, and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra, the hollow tube that carries urine from the bladder to the outside of the body, and begin to multiply.
Most infections arise from Escherichia coli (E. coli) bacteria, which normally live in the colon.
Signs and symptoms
Lower UTI usually produces urgency, frequency, dysuria, cramps or spasms
Other common features include low back pain, malaise, nausea, vomiting, abdominal pain or tenderness over the bladder area, chills, and flank pain.
Test strips dipped into a urine sample can detect indirect signs of infection such as blood, protein, white blood cells and nitrites (most common bacteria convert nitrate, which is a chemical normally present in urine into nitrites, which are not usually present).
Appropriate antimicrobials are the treatment of choice for most initial lower UTIs. A 7- to 10-day course of antibiotic therapy is standard, but recent studies suggest that a single dose of an antibiotic or a 3- to 5-day antibiotic regimen may be sufficient to render the urine sterile. After 3 days of antibiotic therapy, urine culture should show no organisms.
If the urine is not sterile, bacterial resistance has probably occurred, making the use of a different antimicrobial necessary. Single-dose antibiotic therapy with amoxicillin or co-trimoxazole may be effective in women with acute, noncomplicated UTI. A urine culture taken 1 to 2 weeks later indicates whether the infection has been eradicated.
Recurrent infections due to infected renal calculi, chronic prostatitis, or structural abnormality may necessitate surgery; prostatitis also requires longterm antibiotic therapy. In patients without these predisposing conditions, long-term, low-dosage antibiotic therapy is the treatment of choice.
If you are prone to UTIs, your doctor may recommend taking antibiotics more regularly to prevent infection.
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