Question

A 30-year-old lady comes to you with urinary symptoms.
How will you manage urinary tract infection?

Hint:

In uncomplicated UTIs, first-line antibiotics like Nitrofurantoin are highly effective. For recurrent or complicated UTIs, consider longer courses or prophylactic therapy.

Answer 1

Step 1: Antibiotic Therapy.
First-line antibiotic treatment for uncomplicated UTIs usually includes Trimethoprim-Sulfamethoxazole, Nitrofurantoin, or Fosfomycin. In complicated UTIs or in patients with pyelonephritis, broader-spectrum antibiotics such as Ciprofloxacin or Amoxicillin-Clavulanate may be used. Antibiotics should be selected based on urine culture results to ensure effective treatment.

Step 2: Pain Relief.
Pain relief can be provided using Phenazopyridine, a urinary analgesic, to relieve symptoms such as dysuria. Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen can also help with pain and inflammation.

Step 3: Hydration.
Encouraging adequate hydration is important in promoting urine flow, which can help flush bacteria from the urinary tract. Patients should be advised to drink plenty of fluids, especially water.

Step 4: Management of Risk Factors.
Management of any underlying risk factors, such as controlling diabetes, addressing urinary retention, or catheter care, is critical in preventing recurrent UTIs. For recurrent infections, prophylactic antibiotics may be considered.

Step 5: Follow-up and Prevention.
Follow-up is essential to ensure the infection has resolved. In cases of recurrent UTIs, further investigation, including imaging or urological consultation, may be needed. Preventive measures such as proper hygiene, frequent urination, and, in some cases, low-dose antibiotics for prevention, should be considered.

Step 6: Conclusion.
UTI management involves antibiotics, pain relief, and addressing underlying risk factors. Appropriate follow-up is essential to ensure effective resolution and prevent recurrence.