Diagnosis
can be made when symptoms and signs are present, in addition to pyuriasymptoms include : Urgency, Frequency, Burning micturation
urine analysis
WBCs > 5 hpf
Bacteria
Nitrite Positive
3. urine culture
E coli is the most common causative organism
differentiation between complicated and non complicated infection
complicated infection : when
Immunosuppresed : DM, HIV
Indwelling catheter
Urinary obstruction
Congenital anomalies : vesicoureteric reflux, pelviureteric junction obstruction
Sones
Treatment
In non complicated cases
Initial empirical therapy
Nitrofurantoin
100 mg twice daily for 5 days
Trimethoprim-Sulfamethoxazole
160/800 mg twice daily for 3 days
Fosfomycin 3 g single dose ( less effective)
Basic concepts of treatment
Floroquinolones are not the first line of treatment
Amoxicillin & Ampicillin should not be used as empirical treatment
alternative empirical therapy includes
Floroquinolones for 5 days
Beta lactams for 7 days
Adjust antibiotics based on urine culture