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Urinary Tract Infection

By Staff

8/20/2014

US Pharm. 2014;39(8):17-18. 

Cystitis or Bladder Infection

A urinary tract infection, or UTI, is an infection of a part of the urinary tract. Bladder infections are common, especially in women. Symptoms can include pain and burning upon urination, constant need to urinate, and cloudy or bloody urine with a foul smell. Sometimes the infection causes inflammation of the urethra, the tube at the base of the bladder through which urine empties. Infection can also affect the kidneys, a more serious condition with symptoms of fever, pain in the lower back, nausea, or confusion.

Most UTIs are caused by bacteria, and they are treated with antibiotics. Infections contained in the bladder only (cystitis) are bothersome, but rarely serious. Infections of the kidney (pyelonephritis) are less common, but they can lead to scarring and kidney damage if left untreated.

Women Are More Prone to UTIs Than Men

The urinary tract is made up of the kidneys, ureters, bladder, and urethra. Urinary tract infections (UTIs) are usually caused by bacteria that enter through the urethra and travel into the bladder. Bladder infection (cystitis) is more common in women because the urethra is close to the vagina and rectum, which are sources of bacteria. A bladder infection can spread to the kidneys through the ureters, although this is not common.

Risk Factors

One condition that increases the risk of UTI is not completely emptying the bladder while urinating. This can occur in spinal cord injuries, or with a blockage such as a kidney stone. An indwelling catheter used to assist with urination over a period of time increases the risk of bacteria living in the bladder. People with diabetes or poor immunity are more likely to suffer from infections of the urinary tract. Pregnant women are at increased risk for kidney infections, possibly owing to a repositioning of the urinary tract that allows bacteria to travel back up the ureters from the bladder.

Some women develop urinary symptoms after sex because of bacteria entering the urethra. After menopause, women are more likely to suffer from bladder infections because low estrogen levels lead to an increase in vaginal bacteria that often cause UTIs. Men are much less likely to suffer from UTIs, but infection can occur if an enlarged prostate gland interferes with urination.

Diagnosis and Treatment

Diagnosis of UTI is made when symptoms occur with a positive urine test. A urine test will show bacteria, white blood cells, red blood cells, and/or nitrites (a chemical produced by bacteria) if it is positive for infection. A urine sample is collected by the clean catch method to avoid contamination. When the urine is cultured in a laboratory, the bacteria can be identified and the test will show which antibiotics will be effective to cure the infection.

Treatment of a UTI is based on the location of the infection and the bacteria causing it. For a bladder infection or mild kidney infection, an oral antibiotic is used for 3 to 14 days. Drinking plenty of fluids and finishing all the medicine is very important, even if symptoms improve. For a serious kidney infection, treatment with IV antibiotics and fluids may be needed during a short hospital stay.

Recurrent UTIs and Prevention

UTIs often recur, even if they are adequately treated with antibiotics. Women who suffer from repeated UTIs may be treated with a low dose of antibiotic daily for several months. If symptoms are associated with sexual contact, a single dose of antibiotic may be used immediately afterward to prevent infection.

Women should wipe from front to back after a bowel movement to prevent bacteria from entering the urethra. Daily cranberry juice or cranberry extract capsules, as well as probiotic supplements, are being studied to determine their role in preventing chronic UTIs.

To comment on this article, contact rdavidson@uspharmacist.com.

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