Urinary
Tract Infections (UTI), account for approximately 7 million visits
to physicians each year. While many individuals have one or two infections
per year, others suffer repeated discomforting episodes on a more
frequent basis. Most commonly it is young women who suffers from UTI,
although men, typically in their later years, may also develop UTI.
There are several factors that result in the development of a UTI.
The most common reason for infection is the growth of bacteria in
the urinary bladder. The bacteria live on the surface of the urethra,
which connects the bladder to the external surface of the body. Particular
bacteria are very adept at attaching to the surface of the urethra
and migrating up into the bladder. Particular factors can help facilitate
this migration. The most common activity resulting in increased UTI
is sexual intercourse. Increased frequency of intercourse or the onset
of intercourse may lead to a UTI. Unfortunately commonly held beliefs
such as avoiding soon after sex or drinking cranberry juice have never
been proven to decrease the incidence of infection. In addition the
use of spermicides and the use of a diaphragm may also increase the
risk of developing a UTI.
The symptoms of a UTI are very common to most women. While many women
may be asymptomatic and not even realize that they have UTI. Most
experience dysuria (pain on urination), increased frequency (increased
in number of times), urgency (the heightened sensation for the need
to urinate), and pain in the lower part of the abdomen. For many individuals
the pain can be quite severe and can even prevent daily activities.
The diagnosis of a urinary tract infection is primarily based on symptoms
and on examining the urine for the presence of the infection fighting
white blood cells. These cells produce a substance known as a leukocyte
esterase, which can be readily detected by a chemical reaction. In
addition many bacteria also produce substances known as nitrates,
which can also be detected. These routine tests on urine can be easily
done in a matter of seconds at your local doctor's office. Typically
this is all that is required in detecting a routine infection. However,
if an individual suffers repeated infections it is often wise for
the physician to send a sample of urine so that the bacteria causing
the infection can be identified and the appropriate antibiotics started.
As for treating common UTI the mainstay of treatment is an antibiotic.
In the past amoxicillin, sulfa drugs or nitrofurantoin
were used. While these medications are often effective as many as
30 percent of bacteria will be resistant to their actions. This has
prompted the use of antibiotics such as trimethoprim/sulfamethoxazole,
commonly known as Bactrim, or trimethoprim alone to
treat simple, uncomplicated UTI. In situations where UTI's are recurrent,
urinary culture is recommended and more powerful antibiotics like
quinolones may have to be used. Some common quinolones include
ciprofloxacin, ofloxacin and levofloxacin. Typically
three days of antibiotics is all that is required. There is no advantage
to seven days of antibiotic treatment, however three days is superior
to a one-time dose. In addition pyridium may be used to decrease
the pain associated with the UTI. Pyridium is taken twice a
day for three days. It should be noted that pyridium will turn
the urine orange and can stain underwear and clothing.
If the pain and frequency associated with the UTI is accompanied by
high fevers, chills and pain in the flanks, one should make their
doctor aware of the symptoms as they may indicate a more serious infection
higher up in the urinary tract affecting the kidneys.
While UTI's occur primarily in women, men may also be infected. In
men this typically occurs in the older population as symptoms of urinary
retention from prostate enlargement develop. Men are typically treated
for seven days as opposed to three to insure that the prostate is
cleared of bacteria. Once again a urine culture may be necessary to
insure proper antibiotic coverage.
Finally women with recurrent UTI may be given a prescription for antibiotics
to be taken at the first sign of infection. This often reduces the
length of symptoms and clears the bacteria more readily. As always
these options should be discussed with your own physician.
Feature Archives