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04.05.2016
Contrary to popular belief, indulging in delicious food is a key part of living a healthy life. Guidelines recommend using nitrofurantoin or trimethoprin-sulfamethoxazole as first-line antibiotic treatments for UTIs.
Complicated Urinary Tract InfectionsComplicated infections, which occur in men and women of any age, are also caused by bacteria but they tend to be more severe, more difficult to treat, and recurrent.
All older adults who are immobilized, catheterized, or dehydrated are at increased risk for UTIs.
MedicationsAlthough antibiotics are the first treatment choice for urinary tract infections, antibiotic-resistant strains of E.
Sexual PrecautionsSexual intercourse is one of the most common risk factors for uncomplicated UTIs in women.
Sticks and stones may break my bones but words will only cause permanent psychological damage. Sometimes the girl who’s always been there for everyone else needs someone to be there for her. I think i’m afraid to be happy because whenever I get to happy, something bad always happens. I wish I could go back to a time when i could smile and it didn’t take everything in me to do it.
You go home, you look in the mirror, you cry, you think you are ugly, you think you are fat, you want to die and the worst thing is, the next day it happens all over again until the day you give up.
I don’t think anyone could ever criticize me more severly than the way I viciously criticize myself. Maybe this year Ill get myself off of the floor and try to pretend that things are getting better, That I’m changing but I still feel the same. That moment when you can actually feel the pain in your chest from seeing or hearing something that breaks your heart. It feels like everyone else is moving on with their lives while I am stuck here in this hole that I can’t climb out of.
Here’s the catch, there are only going to be 1,500 of these shoes produced and all will be auctioned on eBay to the highest bidder.  Get ready to stand in line behind people with deep pockets, because once these things get a bid over $88 it is going to get bananas! Fluoroquinolones (such as ciprofloxacin) are now only recommended when other antibiotics are not appropriate.Cranberries for UTI ProtectionCranberry products may help prevent UTIs in some women especially those with recurrent infections, indicates a 2012 review of studies.
The urinary system helps maintain proper water and salt balance throughout the body and also expels urine from the body. Frequent or recent sexual activity is the most important risk factor for urinary tract infection in young women. The longer any urinary catheter is in place, the higher the risk for growth of bacteria and an infection. Nursing home residents, particularly those who are incontinent, are at very high risk.Medical Conditions that Increase the Risk of UTIsDiabetes. A variety of antibiotics are available, and choices depend on many factors, including whether the infection is complicated or uncomplicated or primary or recurrent. In addition to abstaining from sex while you have a UTI, the following recommendations may reduce the risks from sexual activity:Keep the genital and anal areas clean before and after sex.
The only issue is that overdoing it—even if it’s not necessarily on unhealthy food!—can leave you feeling bloated and sluggish. Drinking several glasses of cranberry juice a day appeared to offer more protection than taking cranberry tablets. It is made up of the following organs and structures:The two kidneys, located on each side below the ribs and toward the middle of the back, play the major role in this process. About 25 - 50% of these women can expect another infection within a year of the previous one.
Nearly 80% of all urinary tract infections in premenopausal women occur within 24 hours of intercourse.
The spring-rim of the diaphragm can bruise the area near the bladder, making it susceptible to bacteria. Treatment decisions are also based on the type of patient (man or woman, a pregnant or nonpregnant woman, child, hospitalized or nonhospitalized patient, or person with diabetes). Urinate before and after intercourse to empty the bladder and cleanse the urethra of bacteria. The images and messages posted on these sites are a raw look into the thoughts and struggles of many thousands of depressed individuals. There can also be a creeping sense of guilt, even though overeating sometimes is normal and will in no way ruin your healthy-lifestyle goals. If bacterial infection spreads to the kidneys and ureters, the condition is called pyelonephritis. Researchers think that cranberries help prevent harmful bacteria from attaching and sticking to urinary tract cells.IntroductionA urinary tract infection (UTI) is a condition in which one or more parts of the urinary system (the kidneys, ureters, bladder, and urethra) become infected. Spermicidal foam or gel used with diaphragms, and spermicidal-coated condoms, also increase susceptibility to UTIs. Because of the risk for wider infection, however, anyone requiring a catheter should be screened for infection. Vaginitis is a common vaginal infection that can be caused by a yeast (candidiasis) or bacteria. A doctor may also select an antibiotic based on the resistance rate in that geographic area. Discuss with your doctor contraceptive alternatives to the spermicides used with condoms and diaphragms.
Try to understand the blackness, lethargy, hopelessness and loneliness ther’re going through. UTIs are the most common of all bacterial infections and can occur at any time in the life of an individual. The pelvic floor is a muscular structure similar to a sling running between the pubic bone in front to the base of the spine.The bladder stores the urine. However, UTIs are NOT sexually transmitted infections.In general, it is the physical act of intercourse itself that produces conditions that increase susceptibility to the UTI bacteria, with some factors increasing the risk. Most spermicides contain nonoxynol-9, a chemical that is associated with increased UTI risk.Pregnancy. Longer courses (7 - 10 days) work no better than the 3-day course and have a higher rate of side effects.TMP-SMX should not be used in patients who are allergic to sulfa drugs. Pyelonephritis is an upper urinary tract infection and is much more serious.Risk FactorsWomen are more susceptible to urinary tract infections than men, and their infections tend to recur. Nearly 95% of cases of UTIs are caused by bacteria that typically multiply at the opening of the urethra and travel up to the bladder. When the bladder becomes filled, the muscle in the wall of the bladder contracts, and the urine leaves the body via another tube called the urethra. A reinfection occurs several weeks after antibiotic treatment has cleared up the initial episode and can be caused by the same bacterial strain that caused the original episode or a different one.
In pregnant women, the presence of asymptomatic bacteriuria is associated with increased risk of kidney infection, which can cause early labor and other serious pregnancy complications.
Nearly any kidney disorder, including kidney stones, increases the risk for complicated UTIs.Neurogenic Bladder. The typical symptoms of vaginitis are itching and an abnormal discharge.Sexually Transmitted Diseases.
For example, if a woman has symptoms, even if bacterial count is low or normal, infection is probably present, and the doctor should consider antibiotic treatment.Treatment for Uncomplicated UTIsUTIs can often be successfully treated with antibiotics prescribed over the phone. This can cause many health problems, including sexually transmitted diseases.Cranberries, Blueberries, and LignonberriesCranberries, blueberries, and lignonberry, a European relative of the cranberry, are three fruits that appear to have protective properties against urinary tract infections. One reason is that the urethra (the tube that carries urine away from the bladder) is shorter in women than in men. The infecting organism is usually introduced through fecal bacteria and moves up through the urinary tract.Relapse.
For this reason, pregnant women should be screened and treated for asymptomatic bacteriuria.
A number of brain and nerve disorders can affect the nerves of the bladder and cause problems with the ability to empty the bladder and control urine leakage.
Women with painful urination whose urine does not exhibit signs of bacterial growth in culture may have a sexually transmitted disease.
In such cases, a health professional provides the patients with 3-day antibiotic regimens without requiring an office urine test. Trimethoprim (such as Proloprim or Trimpex) is sometimes used alone in those allergic to sulfa drugs. Pregnant women are more susceptible to kidney infection because as the uterus enlarges it compresses the ureters and bladder. Multiple sclerosis, stroke, spinal cord injury, and diabetic neuropathy are common examples.Sickle-Cell Anemia.
This course is recommended only for women who have typical symptoms of cystitis, who are at low risk for recurrent infection, and who do not have symptoms (such as vaginitis) suggesting other problems.Antibiotic Regimen. It is diagnosed when a UTI recurs within 2 weeks of treatment of the first episode and is due to treatment failure. Patients with sickle-cell anemia are particularly susceptible to kidney damage from their disease, and UTIs put them at even greater risk.Immune System Problems.


Other STDs that may be responsible include gonorrhea and genital herpes.Interstitial Cystitis.
Oral antibiotic treatment cures nearly all uncomplicated urinary tract infections, although the rate of recurrence remains high.
High rates of bacterial resistance to TMP-SMX exist in many parts of the United States.NitrofurantoinNitrofurantoin (Furadantin, Macrodantin, Macrobid, generic) is an antibiotic that is used specifically for urinary tract infections as an alternative to TMP-SMX. When women reach menopause, the decrease in estrogen thins the lining of the urinary tract, which increases susceptibility to bacterial infections.Pregnancy does not increase the risk of getting a urinary tract infection but it can increase the risk of developing a serious infection that could potentially harm the mother and fetus. A number of defense systems protect the urinary tract against infection-causing bacteria:Urine functions as an antiseptic, washing potentially harmful bacteria out of the body during normal urination.
Relapse usually occurs in kidney infection (pyelonephritis) or is associated with obstructions such as kidney stones, structural abnormalities or, in men, chronic prostatitis.Asymptomatic Urinary Tract Infection (Asymptomatic Bacteriuria)When a person has no symptoms of infection but significant numbers of bacteria have colonized the urinary tract, the condition is called asymptomatic UTI (also called asymptomatic bacteriuria). Interstitial cystitis (IC) is an inflammation of the bladder wall that occurs almost predominantly in women.
The following antibiotics are commonly used for uncomplicated UTIs:The standard regimen is a 3-day course of trimethoprim-sulfamethoxazole, commonly called TMP-SMX (Bactrim, Septra, generic).
Some people have structural abnormalities of the urinary tract that cause urine to stagnate or flow backward into the upper urinary tract. The average age of patients with IC is 40 years old, but 25% of cases occur in women under age 30. Lactobacilli produce hydrogen peroxide, which helps eliminate bacteria and reduces the ability of Escherichia coli (E.
Pregnant women with asymptomatic bacteriuria have an increased risk of acute pyelonephritis in their second or third trimester.
This is primarily due to decrease in estrogen, which thins the walls of the urinary tract and reduces its ability to resist bacteria. A prolapsed bladder (cystocele) can result in incomplete urination so that urine collects, creating a breeding ground for bacteria. A single dose of TMP-SMX is sometimes prescribed in mild cases, but cure rates are generally lower than with 3-day regimens. Older people may have a urinary tract infection but have few or no symptoms.TreatmentAntibiotics are used to treat UTIs.
Pain during sex is a very common complaint in these patients, and stress may intensify symptoms.Kidney Stones. Allergies to sulfa are common and may be serious.Nitrofurantoin (Furadantin, Macrobid, Macrodantin, generic) is another first-line option.
Most cases of UTIs clear up after a few days of drug treatment, but more severe cases may require several weeks of treatment.
Guidelines recommend that pregnant women be screened for asymptomatic bacteriuria at 12 - 16 weeks gestation or at the first pre-natal visit, if later.People undergoing urologic surgery (such as prostate surgery in men).
However, if left untreated, UTIs can develop into very serious and potentially life-threatening kidney infections (pyelonephritis) that can permanently scar or damage the kidneys. The pain of kidney stones along with blood in the urine can resemble the symptoms of pyelonephritis. It is usually taken daily for 5 days.Fosfomycin (Monurol) is not as effective as other antibiotics but may be used during pregnancy.
It should not be used in pregnant women within 1 - 2 weeks of delivery, in nursing mothers, or in those with kidney disease.FosfomycinThe antibiotic fosfomycin (Monurol) may be prescribed as a 1-dose treatment for women who are pregnant or for other select patients. For some women, topical estrogen therapy helps restore healthy bacteria and reduce the risk of recurrent UTIs. The infection may also spread into the bloodstream (called sepsis) and elsewhere in the body.UTIs in pregnant women pose serious health risks for both mother and child.
There are no bacteria present with kidney stones, however.Thinning Urethral and Vaginal Walls. Resistance rates to this drug are very low.Fluoroquinolone antibiotics, also called quinolones, are only recommended for UTIs when other antibiotics cannot be used. UTIs that occur during pregnancy pose a higher than average risk of developing into kidney infections.
After menopause, the vaginal and urethral walls become dry and fragile, causing pain and irritation that can mimic a UTI.Disorders in Children that Mimic UTIs. Until recent years, the standard treatment for a UTI was 10 days of amoxicillin, a penicillin antibiotic, but it is now ineffective against E.
Women who have skin allergies to ingredients in soaps, vaginal creams, bubble baths, or other chemicals that are used in the genital area are at increased risk for UTIs. Any pregnant woman who suspects she has a urinary tract infection should immediately contact her doctor.
Problems that might cause painful urination in children include reactions to chemicals in bubble bath, diaper rashes, and infection from the pinworm parasite.Prostate Conditions in Men. If it spreads to the vaginal opening, it may invade and colonize the bladder, causing an infection. In such cases, the allergies may cause small injuries that can introduce bacteria.Antibiotic Use. Many doctors recommend that women receive periodic urine testing throughout their pregnancies to check for signs of bacterial infection.In some adults, recurrent UTIs may cause scarring in the kidneys, which over time can lead to renal hypertension and eventual kidney failure.
Pregnant women should not take these drugs.Other antibiotics may also be used, including amoxicillin-clavulanate cefdinir, cefaclor, and cefpodoxime-proxetil. A combination of amoxicillin-clavulanate (Augmentin) is sometimes given for drug-resistant infections.Cephalosporins. Antibiotics often eliminate lactobacilli, the protective bacteria, along with harmful bacteria. Most of these adults with kidney damage have other predisposing diseases or structural abnormalities. Antibiotics known as cephalosporins are alternatives for infections that do not respond to standard treatments or for special populations. They are usually given in 3 - 7 day regimens.After a week of antibiotic treatment, most patients are free of infection.
In most cases, the infection is brief and acute and only the surface of the bladder is infected. If the symptoms do not clear up within the first few days of therapy, doctors generally suggest that women discontinue their antibiotic and provide a urine sample for culturing in order to identify the specific organism causing the condition.Treatment for Relapsing Infection. Cephalosporins used for treatment of UTIs include cephalexin (Keflex, generic), cefadroxil (Duricef, generic) cefuroxime (Ceftin, generic),loracarbef (Lorabid), and cefixime (Suprax), among others.Other Beta-Lactam Drugs.
Deeper layers of the bladder may be harmed if the infection becomes persistent, or chronic, or if the urinary tract is structurally abnormal.Pyelonephritis (Kidney Infection).
Benign prostatic hyperplasia (BPH), enlargement of the prostate gland, can produce obstruction in the urinary tract and increase the risk for infection. A relapsing infection (caused by treatment failure) occurs within 3 weeks in about 10% of women. In men, recurrent urinary tract infections are also associated with prostatitis, an infection of the prostate gland. Relapse is treated similarly to a first infection, but the antibiotics are usually continued for 7 - 14 days. Although only about 20% of UTIs occur in men, these infections can cause more serious problems than they do in women. It is not available in the United States.Fluoroquinolones (Quinolones)Fluoroquinolones (also simply called quinolones) were used as alternatives to TMP-SMX but they are now recommended for UTIs only when other antibiotics are not appropriate. A woman's own perception of discomfort can generally guide her decisions on whether or not to use preventive antibiotics.
Specific Risk Factors in ChildrenEach year, about 3% of American children develop urinary tract infections. All women should use lifestyle measures to prevent recurrences.Intermittent Self Treatment. Examples of quinolones include ofloxacin (Floxacin, generic), ciprofloxacin (Cipro, generic), and levofloxacin (Levaquin, generic). Many, if not most, women with recurrent UTIs can effectively self-treat recurrent UTIs without going to a doctor. These drugs can have severe side effects that the patient should discuss with the doctor.Pregnant women should not take fluoroquinolone antibiotics.
For example, beneficial organisms called lactobacilli increase the acidic environment in the female urinary tract.
Boys who are uncircumcised are about 10 - 12 times more likely than circumcised boys to develop UTIs by the time they are 1 year old. In general, this requires the following steps:As soon as the patient develops symptoms, she takes the antibiotic. They also have more adverse effects in children than other antibiotics and should not be the first-line option in most pediatric situations.Other Antibiotics Used for UTIsDoripenem.
Reductions in their number (which, for example, occur with estrogen loss after menopause), increase pH and therefore the risk of infection.Risk FactorsAfter the flu and common cold, urinary tract infections (UTIs) are the most common medical complaint among women in their reproductive years. Doripenem (Doribax) is a newer carbapenem antibiotic, which is used to treat complicated urinary tract infections. If recurrent infections are clearly related to sexual activity and episodes recur more than two times within a 6-month period, a single preventive dose taken immediately after intercourse is effective. Most women will develop a UTI at some time in their lives, and many will have recurrences.Specific Risk Factors in WomenStructure of the Female Urinary Tract.


Concomitant illness may further confuse the picture and make diagnosis difficult.DiagnosisA doctor can confirm if you have a urinary tract infection by testing a sample of your urine.
Antibiotics for such cases include TMP-SMX, nitrofurantoin, cephalexin, or a fluoroquinolone (such as ciprofloxacin). In general, the higher risk in women is mostly due to the shortness of the female urethra, which is 1.5 inches compared to 8 inches in men. Vesicoureteral reflux (VUR)  is the cause of up to half of urinary tract infections that occur during childhood.
For some younger women who are at low risk of complications, the doctor may not order a urine test and may diagnose a urinary tract infection based on the description of symptoms.Urine TestsUrinalysis. Bacteria from fecal matter at the anal opening can be easily transferred to the opening of the urethra. VUR also puts children at risk for UTI recurrence.VUR is a condition in which the urine backs up into the kidneys.
Continuous preventive (prophylactic) antibiotics are an option for some women who do not respond to other measures.
Normally, when the bladder becomes filled, the muscle in the wall of the bladder contracts, and the urine leaves the body via another tube called the urethra. It involves looking at the urine color and clarity, using a special dipstick to do different chemical testing, and possibly inspecting some of the urine underneath a microscope. With this approach, low-dose antibiotics are taken continuously for 6 months or longer.Treatment for Kidney Infections (Pyelonephritis)Patients with uncomplicated kidney infections (pyelonephritis) may be treated at home with oral antibiotics.
A urinalysis usually provides enough information for a doctor or nurse to start treatment.Urine Culture. Ciprofloxacin (Cipro, generic) or another fluoroquinolone is typically given but other antibiotics, such as trimethoprim-sulfamethoxazole, may be used. Aminoglycosides (gentamicin, tobramycin, amikacin) are given by injection for very serious bacterial infections. These valves' job is to keep urine from flowing backward towards the kidneys when the bladder contracts. If necessary, the doctor may order a urine culture, which involves incubating and growing the bacteria contained in the urine. Patients with moderate-to-severe acute kidney infection and those with severe symptoms or other complications may need to be hospitalized.
A urine culture can help identify the specific bacteria causing the infection, and determine which type of antibiotics to use for treatment. A urine culture may be ordered if the urinalysis does not show signs of infection but the doctor still suspects a UTI is causing the symptoms. Chronic pyelonephritis may require long-term antibiotic treatment.Treatments for Specific PopulationsTreating Pregnant Women. They can have very serious side effects, including damage to hearing, sense of balance, and kidneys.Medications for Treating SymptomsAlthough antibiotics can cure most urinary tract infections, severe symptoms can persist for several days until the drug eliminates the bacteria. It may also be ordered if the doctor suspects complications from the infection.Clean-Catch Sample.
Pregnant women should be screened for UTIs, since they are at high risk for UTIs and their complications.
Other medications may be used for relieving symptoms until the antibiotics take action.Phenazopyridine.
To obtain an untainted urine sample, doctors usually request a so-called midstream, or clean-catch, urine sample. The antibiotics used during pregnancy include amoxicillin, ampicillin, nitrofurantoin, and cephalosporins. Phenazopyridine (such as Pyridium, Uristat, AZO Standard, Urodol, generic) relieves pain and burning caused by the infection. To provide this, the following steps are taken:Wash your hands thoroughly, then wash the penis or vulva and surrounding area four times, with front-to-back strokes, using a new soapy sponge each time. Patients should not take this medicine for more than 2 days.Side effects include headache and upset stomach.
In general, there is no consensus on which antibiotic is best for pregnant women although some types of antibiotics, such as fluoroquinolones and tetracyclines, should not be taken as they can cause harm to the fetus.Pregnant women with asymptomatic bacteriuria (evidence of infection but no symptoms) have a 30% risk for acute pyelonephritis in their second or third trimester.
The drug turns urine a red or orange color, which can stain fabric and be difficult to remove. Rarely, it can cause serious side effects, including shortness of breath, a bluish skin, a sudden reduction in urine output, shortness of breath, and confusion. Remove the cup and urinate the remainder of your flow into the toilet.Securely screw the container cap in place without touching the inside of the rim and place it where directed.
For an uncomplicated UTI, pregnant women may need longer-term antibiotics (7 - 10 days).Treating Children with UTIs.
Methenamine (Urised, Cystex, generic) or flavoxate (Urispas, generic) reduce bladder spasms, which may occur with some UTIs. The sample will be given to the doctor or sent to the laboratory for analysis.Collection with a Catheter.
These drugs can have severe side effects, however, that the patient should discuss with the doctor.Lifestyle ChangesAlthough there is no evidence that good hygiene makes a real difference in preventing UTIs, it is always a wise practice. Some patients (small children, elderly people, or hospitalized patients) cannot provide a urine sample. This is the best method for providing a contaminant-free sample, but it carries a risk of introducing or spreading infection.Other TestsIf the infection does not respond to treatment, the doctor may order other tests to determine what is causing symptoms. Children usually respond to treatment within a few days.Vesicoureteral reflux (VUR) is a concern for children with UTIs. As a general rule, do not use any product containing perfumes or other possible allergens near the genital area. Douching is never recommended as it may irritate the vagina and urethra and increase the risk of sexually transmitted diseases.Choose sanitary napkins instead of tampons (which some doctors believe encourage infection). Special x-rays can be used to screen for structural abnormalities, urethral narrowing, or incomplete emptying of the bladder:Voiding cystourethrogram is an x-ray of the bladder and urethra. The two treatment options for children with VUR are long-term antibiotics to prevent infections or surgery to correct the condition. Napkins and tampons, in any case, should be changed after each urination.Drink plenty of fluids and urinate frequently.
To obtain a cystourethrogram, a dye, called contrast material, is injected through a catheter inserted into the urethra and passed through the bladder.An intravenous pyelogram (IVP) is an x-ray of the kidney. Appropriate hygiene and cleanliness of the genital area may help reduce the chances of introducing bacteria through the urethra. For a pyelogram, the contrast matter is injected into a vein and eliminated by the kidneys.
Current guidelines advise that antibiotics do not really help prevent recurrent urinary tract infections in children, and that VUR itself may not substantially increase the risk for recurrent UTIChildren with acute kidney infection are treated with various antibiotics including oral cefixime (Suprax) or a short course (2 - 4 days) of an intravenous (IV) antibiotic (typically gentamicin, given in one daily dose). Females are especially vulnerable to this, because the urethra is in close proximity to the rectum. An oral antibiotic then follows the IV.Management of Catheter-Induced Urinary Tract InfectionsCatheter-induced urinary tract infections are very common, and preventive measures are extremely important.
The genitals should be cleaned and wiped from front to back to reduce the chance of dragging E.
Cystoscopy is used to detect structural abnormalities, interstitial cystitis, or masses that might not show up on x-rays during an IVP. In-dwelling catheters should not be used unless absolutely necessary, and they should be removed as soon as possible. Reducing the risk for infections during long-term catheter use, however, remains problematic. A typical catheter is one that has been preconnected and sealed and uses a drainage bag system. Patients using catheters who develop UTIs with symptoms should be treated for each episode with antibiotics and the catheter should be removed, if possible, or changed.
A major problem in treating catheter-related UTIs is that the organisms involved are constantly changing. Because there are likely to be multiple species of bacteria, doctors generally recommend an antibiotic that is effective against a wide variety of microorganisms.Although high bacteria counts in the urine (bacteriuria) occur in most catheterized patients, administering antibiotics to prevent a UTI is rarely recommended.
Many catheterized patients do not develop symptomatic urinary tract infections even with high bacteria counts.
If bacteriuria occurs without symptoms, antibiotic therapy has little benefit if the catheter is to remain in place for a long period.
Catheterization is accomplished by inserting a catheter (a hollow tube, often with an inflatable balloon tip) into the urinary bladder.
This procedure is performed for urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia or coma), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured.
Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.



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