Urinary tract infection


Urinary tract infection

Risk factors

Risk factors for UTIs in younger women 
Sexual intercourse
Contraceptive diaphragms (especially with spermicides)
 Past history of childhood
Risk factors in postmenopausal women

Urinary incontinence


Atrophic vaginitis

History of UTIs before menopause.

Clinical features

Urinary frequency

Urinary burning


Abdominal pain- loin/ lower abdominal



Urine dipstick

Urine MCS

U/s KUB if recurrent UTI

Other investigations as per age and possible cause of UTI

Treatment choices


Simple UTI should be treated with empirical first-line antibiotic therapy such as trimethoprim 300 mg orally at night for 3 days or cephalexin 500 mg orally twice daily for 5 days

Other options include

Amoxycillin with clavulanate


For complex UTI— Quinolones


In pregnant women, trimethoprim is contraindicated so  cephalexin is recommended

Patients with recurrent UTI where other causes, of UTI, have been excluded, can be offered the following options

Continuous prophylaxis

3–6 months  duration of  Trimethoprim 150 mg daily

Cephalexin 250 mg nocte

Nitrofurantoin 50 mg nocte

Trimethoprim + sulphamethoxazole 160/800 mg

Self start therapy

Trimethoprim nocte for 3 days

Cephalexin 500 mg bd for 5 days

Nitrofurantoin 50mg 6 hourly for 3 days

Norfloxacin 400 mg bd for 3 days

Augmentin 500/125 mg bd for 5 days

Post intercourse—stat dose of the above medications


Nitrofurantoin side effects that need to be considered with prolonged therapy

1- Interstitial pulmonary fibrosis

2- Peripheral neuropathy (usually beginning with lower limb paraesthesia)

3 – Hepatotoxicity (chronic active hepatitis)

error: Content is protected !!