Today in Health & Wellness
HEALTH CONDITIONS
Urinary Tract Infection
Overview
Symptoms
Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Home Remedies
Doctors to Consult
Overview

Urinary tract infection (UTI) can happen anywhere along the urinary tract - the kidney (pyelonephritis), the ureters, the bladder (cystitis), or the urethra (urethritis). Left untreated, it can lead to acute or chronic pyelonephritis which can permanently damage the kidneys.

Women are more prone to UTIs because their urethras are shorter and closer to the anus. UTIs are most common in sexually active women, in diabetics and people with sickle-cell disease or anatomical malformations of the urinary tract.

Symptoms
  • Persistent urge to urinate
  • Burning sensation when urinating
  • Passing frequent, small amounts of urine
  • Blood in the urine (hematuria) or cloudy, strong-smelling urine
  • Flank pain, high fever, shaking chills and nausea or vomiting (associated with pyelonephritis)
  • Pressure in the pelvis and lower abdomen and strong smelling urine (associated with cystitis)
  • Pus in urine and genital discharge (associated with urethritis)
Risk Factors
  • Escherichia coli (E. coli) (bacteria from the digestive tract), causes about 80% of UTIs in adults. Normally present in the colon, it may enter the opening of the urethra and begin to multiply.
  • Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in both men and women, but these infections tend to remain limited to the urethra and the reproductive system. These micro-organisms may be sexually transmitted.
  • For Men: Benign Prostatic Hypertrophy (BPH), Cognitive impairment, fecal incontinence, urinary incontinence, anal intercourse, infection of the prostate, immune system disorders.
  • For Women: Previous UTI, DM, Pregnancy, more frequent or vigorous sexual activity than usual, underlying condition of the urinary tract (e.g., tumors or stones)
Commonly Prescribed Drugs

Antibiotics are the first line of treatment for most UTIs. The treatment regimen will depend on the patient's health condition and the bacteria found in urine tests.

  • Sulfonamides (sulfadiazine, sulfamethoxazole, sulfisoxazole). They kill the bacterium by interfering with para-aminobenzoic acid (PABA), the enzyme that helps form folic acid a chemical necessary for bacterial growth.
    • Drug Interaction: Sulfonamides should not be given with anticoagulants, barbiturate anesthetics, hydantoins, sulfonylureas, diuretics and salicylates.
  • Trimethoprim inhibits bacterial growth by blocking the production of dihydrofolate reductase, an enzyme that completes the synthesis of proteins and nucleic acids needed by bacterial cells to multiply. Phenytoin's pharmacologic effects may be increased with co-administration of trimethoprim.
  • Quinolones (ciprofloxacin, gatifloxacin, norfloxacin, levofloxacin, ofloxacin, pefloxacin) works by inhibiting the enzymes (DNA gyrase, topo-isomerase IV) responsible for bacterial DNA replication.
  • Penicillins (amoxicillin, ampicillin, amoxicillin clavulanic acid, cloxacillin, sultamicillin) interferes with bacterial cell wall synthesis.
    • Drug Interaction: Penicillins should not be given with oral contraceptives, heparin, allopurinol, erythromycin, tetracyclines, cyclosporine and probenecid.
  • Nitrofurantoin interferes with bacterial cell wall formation and bacterial duplication.
    • Drug Interaction: It should not be given with anticholinergic drugs, magnesium salts and probenecid.
  • Other Drugs:
    • Sulfonamide Combinations: Trimethoprim and sulfamethoxazole (Cotrimoxazole) 
    • Aminoglycosides: Amikacin, Gentamicin, Netilmicin.
    • Carbapenems: Ertapenem, Meropenem, Imipenem.
    • 1st Generation Cephalosporins: Cefalexin, Cefradine, Cefadroxyl, Cefazolin.
    • 2nd Generation Cephalosporins: Cefaclor, Cefoxitin, Cefu-roxime.
    • 3rd Generation Cephalosporins: Cefpodoxime, Cefoperazone, Ceftazidime, Ceftriaxone, Ceftizoxime.
    • 4th Generation Cephalosporins: Cefepime.
    • Chloramphenicols: Chloramphenicol.
    • Macrolides: Erythromycin. Monocyclic Beta-lactam
    • Antibiotic: Aztreonam 

Side effects: Rashes, headache, convulsions, drowsiness, nausea, vomiting, GI disturbances, hypersensitivity and renal stones (crystalluria), leukopenia, neutropenia and megaloblastic anemia.

Treatment and Management
  • Drink plenty of fluids, especially water to flush the bacteria from the system.
  • Avoid coffee, alcohol and carbonated drinks containing citrus juices and caffeine. These beverages can irritate the bladder and tend to aggravate frequent or urgent need to urinate.
  • Urinate frequently. Bacteria can grow when urine stays too long in the bladder.
  • Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
  • Empty bladder as soon as possible after intercourse to flush away bacteria that might have entered the urethra during sex.
  • For women, avoid feminine products that can potentially irritate the urethra.
  • Modify birth control method. Diaphragms or spermicides can increase bacteria growth. Unlubricated condoms or spermicidal condoms increase irritation.
  • Wear cotton underwear and loose-fitting clothes so that air can keep the area dry.
  • UTI for children: Seek for Pediatric Nephrologist for consultation.
Home Remedies
  • A heating pad placed over the abdomen can help minimize bladder pressure or pain.
  • Cranberry juice may have infection-fighting properties. It contains chemicals called condensed tannins, or proanthocyanidins, that prevents the bacteria from sticking to the surfaces which line the bladder and bowel.
  • Buko juice is also a popular remedy to help flush out bacteria.
  • Vitamin C increases acidity of urine making it a hostile environment for micro-organisms.
  • Observe proper daily genital hygiene.
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