8/17/2019 UTIs.docx

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Uncomplicated Urinary Tract Infections

Overview: One of the most common diagnoses in the US with ~50%of women experiencing at least one infection during their lifetime and~25% experiencing recurrent infections. E. coli is the most common

cause of uncomplicated UT! comprising "5#$5% of infections. Otherpathogens include S. saprophyticus, Klebsiella! and Proteus.

ommon s&mptoms of acute uncomplicated lower UT: d&suria!fre'uenc&! urgenc&! suprapu(ic pain)tenderness! hematuria. *e+er orcosto+ete(ral angel tenderness indicates upper urinar& tractin+ol+ement.

Diagnosis:,- *or women without a histor& of a la(oratorconrmed UT! an o/ce+isit for urinal&sis or dipstic testing is appropriate. 1ipstic positi+e for

leuoc&te esterase)nitrates in a midstream#+oid supports diagnosis ofUT. Urinal&sis not usuall& necessar& unless a patient fails treatment.2- omen with fre'uent recurrences and prior conrmation (&diagnostic tests who are aware of their s&mptoms ma& (e empiricall&treated

Treatment:,- T34#S3 ,60)700 mg 81 for 9 da&s not recommended in areaswhere local resistance rates exceed 20%! (ecoming an increasingpro(lem in the US-2- ipro;oxacin 250 mg 81 for 9 da&s or O;oxacin 200 mg twice dail&

;uoro'uinolones not rst line (ecause of resistance concerns9- nitrofurantoin monoh&drate)macrocr&stals