Download Lower Urinary Tract Infections (UTI)

 For
infection to occur, bacteria must gain
access to the bladder, attach to and colonize
the epithelium of the urinary tract to avoid
being washed out with voiding, evade host
defense mechanisms, and initiate
inflammation. Many UTIs result from fecal
organisms that ascend from the perineum to
the urethra and the bladder and then adhere
to the mucosal surfaces
 High
incidence of chronic illness
 Frequent use of antimicrobial agents
 Presence of infected pressure ulcers
 Immunocompromise
 Cognitive impairment
 Immobility and incomplete emptying of
bladder
 Use of a bedpan rather than a commode or
toilet
A
variety of signs and symptoms are
associated with UTI. About half of all
patients with bacteriuria have no symptoms.
 Signs and symptoms of an uncomplicated
lower UTI (cystitis) include dysuria (painful
or difficult urination), burning on urination,
frequency (voiding more than every 3 hours),
urgency, nocturia (awakening at night to
urinate), incontinence, and suprapubic or
pelvic pain. Hematuria and back pain may
also be present
 Acute
Pharmacologic Therapy
 The ideal medication for treatment of UTI is
an antibacterial agent that eradicates
bacteria from the urinary tract with minimal
effects on fecal and vaginal flora.
 uncomplicated
UTIs in women is most likely
E. coli or other fecal flora, the agent should
be effective against these organisms
 Various treatment regimens have been
successful in treating uncomplicated lower
UTIs in women: single-dose administration,
short-course (3 to 4 days) regimens, or 7- to
10-day regimens.
 In
a complicated UTI (ie, pyelonephritis), the
general treatment of choice is usually a
cephalosporin or an
ampicillin/aminoglycoside combination.
Patients in institutional settings may require
7 to 10 days of medication for the treatment
to be effective.