Monday, December 5, 2022

Antibiotics And Urinary Tract Infections

What About Antibiotic Resistance

Ask Dr. Nandi: Antibiotic-resistant urinary tract infections are on the rise

Resistance rates for antibiotics are always variable based on local patterns in the community and specific risk factors for patients, such as recent antibiotic use, hospital stay or travel. If you have taken an antibiotic in the last 3 months or traveled internationally, be sure to tell your doctor.

High rates of antibiotic resistance are being seen with both ampicillin and amoxicillin for cystitis , although amoxicillin/clavulanate may still be an option. Other oral treatments with reported increasing rates of resistance include sulfamethoxazole and trimethoprim and the fluoroquinolones. Resistance rates for the oral cephalosporins and amoxicillin/clavulanate are still usually less than 10 percent.

Always finish taking your entire course of antibiotic unless your doctor tells you to stop. Keep taking your antibiotic even if you feel better and you think you don’t need your antibiotic anymore.

If you stop your treatment early, your infection may return quickly and you can develop resistance to the antibiotic you were using previously. Your antibiotic may not work as well the next time you use it.

First Line Antibiotics For A Uti

  • Ampicillin
  • Nitrofurantoin
  • Trimethoprim/sulfamethoxazole

Notably absent from the list of antibiotics prescribed for the treatment of UTIs is Amoxicillin. While very popular and useful in treating numerous other bacterial infections, urinary tract infections are not amongst the infections Amoxicillin is used for.

What To Do If You Suspect A Flutd

If your cat is having trouble urinating and displaying other signs of FLUTD, take her to the vet as soon as possible. Your vet will give her a physical exam and collect urine samples. Blood work, x-rays, and abdominal ultrasound may also be recommended for diagnosis.

Most cases of FLUTD improve without medical treatment, but the symptoms can recur. Though they may not be life-threatening to your cat, they can be uncomfortable, so treatment can improve her overall quality of life. While treatment of FLUTD depends on the underlying cause, it is always beneficial to increase your cats water intake. Maintaining a healthy weight, feeding her canned food and encouraging her to use her litter box can also help. However, certain conditions simply cannot be treated at home. Bacterial cystitis should be treated with antibiotics, while stones must be surgically removed.

Its always best to be safe. A simple phone call to your vet when you first notice any of the above symptoms can help diagnose a problem much sooner and save your cat a longer period of discomfort. Its also important to monitor your cat after being diagnosed with FLUTD during treatment to ensure that the problem doesnt reoccur as cats are good at hiding their pain.

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What Is The Prognosis For A Person With A Urinary Tract Infection

Urinary tract infections typically respond very well to treatment. A UTI can be uncomfortable before you start treatment, but once your healthcare provider identifies the type of bacteria and prescribes the right antibiotic medication, your symptoms should improve quickly. Its important to keep taking your medication for the entire amount of time your healthcare provider prescribed. If you have frequent UTIs or if your symptoms arent improving, your provider may test to see if its an antibiotic-resistant infection. These are more complicated infections to treat and may require intravenous antibiotics or alternative treatments.

What Is Urinary Tract Infection

ASK DIS: Urinary Tract Infection: Antibiotics in Adults

Urinary tract infection is an infection affecting a persons urinary tract. The urinary tract involves the following internal body parts: kidneys, bladder, and urethra.

Here is how they work together. The kidneys are body organs that remove the waste from the blood flowing in them. Meanwhile, the bladder stores this waste or urine. Then, the urethra is the tube carrying the urine from the bladder and out of the body. Urinary tract infections occur when bacteria happen to be in the urine and travel into the bladder.

According to reports from healthcare providers, UTIs are the principal reasons for visits among patients. Besides that, the majority of the patients with reported UTIs are women. It is because women have a shorter urethra than men, making bacteria travel shortly into the bladder.

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Im Pregnant How Will A Uti Affect My Baby

If you have a UTI and it isnt treated, it may lead to a kidney infection. Kidney infections may cause early labor. Fortunately, asymptomatic bacteriuria and bladder infections are usually found and treated before the kidneys become infected. If your doctor treats a urinary tract infection early and properly, it wont hurt your baby.

Which Antibiotic Should Be Used To Treat A Uti

There are multiple types of antibiotics used to treat urinary tract infections . Different treatments may be recommended in different areas of the country based on regional patterns of antibiotic resistance.

Most patients with an uncomplicated UTI will begin treatment without any special diagnostic test, although a urinalysis may be performed by taking a urine sample. In a urinalysis, the chemical components of the urine are determined, and the doctor may look at urine color, clarity, and a view a sample under the microscope. A urine culture may be order, too, but is not always needed to start treatment. A urine culture can define the specific bacteria causing the UTI in more complicated cases or in the case of treatment failure.

Symptoms like burning and stinging while urinating will usually clear up in within one day after starting treatment. Be sure to finish your entire course of medication. If symptoms are still present after 2 to 3 days, contact your healthcare provider.

More extensive diagnostic procedures or imaging tests like an X-ray may be required if you continue to have frequent UTIs.

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Which Antibiotic Will Work Best

Your doctor will take a urine sample to confirm that you have a UTI. Then the lab will grow the germs in a dish for a couple of days to find out which type of bacteria you have. This is called a culture. Itâll tell your doctor what type of germs caused your infection. Theyâll likely prescribe one of the following antibiotics to treat it before the culture comes back:

Which medication and dose you get depends on whether your infection is complicated or uncomplicated.

âUncomplicatedâ means your urinary tract is normal. âComplicatedâ means you have a disease or problem with your urinary tract. You could have a narrowing of your ureters, which are the tubes that carry urine from your kidneys to your bladder, a narrowing in the urethra which transports urine from the bladder out of the body, or, you might have a blockage like a kidney stone or an enlarged prostate . It’s also possible you have a urinary fistula or a bladder diverticulum.

To treat a complicated infection, your doctor might prescribe a higher dose of antibiotics. If your UTI is severe or the infection is in your kidneys, you might need to be treated in a hospital or doctor’s office with high-dose antibiotics you get through an IV.

Your doctor will also consider these factors when choosing an antibiotic:

  • Are you over age 65?
  • Are you allergic to any antibiotics?
  • Have you had any side effects from antibiotics in the past?

Does Cranberry Juice Prevent A Uti

Antibiotic Awareness: Urinary Tract Infection (UTI), Cystitis or Bladder Infection

Some patients may want to use cranberry or cranberry juice as a home remedy to treat a UTI. Cranberry juice has not been shown to cure an ongoing bacterial infection in the bladder or kidney.

Cranberry has been studied as a preventive maintenance agent for UTIs. Studies are mixed on whether cranberry can really prevent a UTI. Cranberry may work by preventing bacteria from sticking to the inside of the bladder however, it would take a large amount of cranberry juice to prevent bacterial adhesion. More recent research suggests cranberries may have no effect on preventing a UTI

  • According to one expert, the active ingredient in cranberries — A-type proanthocyanidins — are effective against UTI-causing bacteria, but is only in highly concentrated cranberry capsules, not in cranberry juice.
  • However, cranberry was not proven to prevent recurrent UTIs in several well-controlled studies, as seen in a 2012 meta-analysis of 24 trials published by the Cochrane group.
  • While studies are not conclusive, there is no harm in drinking cranberry juice. However, if you develop symptoms, see your doctor. Some people find large quantities of cranberry juice upsetting to the stomach.

Increasing fluid intake like water, avoiding use of spermicides, and urinating after intercourse may be helpful in preventing UTIs, although limited data is available.

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Cystitis In Men And Older People

Men tend to get cystitis later in life. Where trouble with urine flow is a symptom, this may indicate that the underlying cause is a problem with their prostate gland.

Cystitis is common in older people, particularly if they are unwell. Bladder catheters and some urinary-tract operations may also increase the risk of cystitis.

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Will I Need An Intravenous Antibiotic For A Uti

If you are pregnant, have a high fever, or cannot keep food and fluids down, your doctor may admit you to the hospital so you can have treatment with intravenous antibiotics for a complicated UTI. You may return home and continue with oral antibiotics when your infection starts to improve.

In areas with fluoroquinolone resistance exceeding 10%, in patients with more severe pyelonephritis, those with a complicated UTI who have allergies to fluoroquinolones, or are unable to tolerate the drug class, intravenous therapy with an agent such as ceftriaxone, or an aminoglycoside, such as gentamicin or tobramycin, may be appropriate. Your ongoing treatment should be based on susceptibility data received from the laboratory.

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What Are The Risks

Antibiotics can have side effects, such as fever, rash, diarrhea, nausea, vomiting, headache, tendon ruptures, and nerve damage.

Antibiotics can cause future problems.

Antibiotics can kill friendly germs in the body. This can lead to vaginal yeast infections. It can also lead to other infections, severe diarrhea, hospitalization, and even death.

Also, antibiotics may help drug resistant bacteria grow. These bacteria are harder to kill. They cause illnesses that are harder to cure. Your health care provider may have to try several antibiotics. This increases the risk of complications. The resistant bacteria can also be passed on to others. If you get an infection from resistant bacteria, you may need more visits and medicines that cost more.

When should older people take antibiotics for a UTI?

If you have UTI symptoms, antibiotics can help.

  • The most common UTI symptom is a painful, burning feeling when you urinate.
  • Other UTI symptoms in older people may include fever, urge to urinate, and frequent urination. Along with these symptoms, there can be pain on one side of the back below the ribs or discomfort in the lower abdomen.

Some kinds of surgery can cause bleeding in the urinary tractfor example, prostate surgery and some procedures to remove kidney stones or bladder tumors. If you are going to have this surgery, you may need testing and treatment for bacteria in urine.

Most Common Bacteria That Cause Utis

ASK DIS: Urinary Tract Infection: Antibiotics in Adults

Based on a study by The National Center for Biotechnology Information, the bacteria most commonly associated with causing UTIs are:

  • Escherichia coli
  • Pseudomonas aeruginosa
  • Enterococci

Based on the symptoms the patient is experiencing and before any testing is done to officially determine the infection type, the doctor prescribes first line antibiotics. For most UTIs, the prescribed antibiotic will cure the infection and not require any further testing.

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Antibiotics For Acute And Uncomplicated Urinary Tract Infections

First-line treatment for an uncomplicated UTI may start with a single dose of fosfomycin or nitrofurantoin twice per day for five days, or sulfamethoxazole-trimethoprim twice per day for three days. These medications can be started based on your symptoms and urinalysis results, and should be effective in most cases.

Although much less common, men may also get this type of UTI. The choice of antibiotics is the same, but they may be given for a longer time because bacteria may move into the prostate gland and take longer to treat.

When doctors diagnose an uncomplicated UTI, they are usually diagnosing a type of UTI called cystitis, which means a bladder infection. In fact, the terms UTI, cystitis and bladder infection are often used interchangeably. Acute uncomplicated cystitis is another medical term for a common UTI that has not spread or become severe.

The term uncomplicated refers to a simple UTI found in a generally healthy adult who:

  • Is not pregnant or postmenopausal
  • Is not immunocompromised
  • Has no structural abnormalities in the urinary tract
  • Has no other diseases

Antibiotics Used For Complicated Utis

Before getting into how to best treat a complicated UTI, its important to understand which UTIs are considered complicated. Here are some guidelines:

  • Urinary tract abnormalities are present
  • Youre pregnant
  • The patient is a child
  • A comorbidity is present that increases risk of infection or treatment resistance, such as poorly controlled diabetes
  • Youre a man, since most UTIs in men are considered complicated
  • Youre elderly

Kidney infections are often treated as a complicated UTI as well, notes the Merck Manual.

If a UTI is complicated, a different course of antibiotics may be required. And the initial dose of antibiotics may be started intravenously in the hospital. After that, antibiotics are given orally at home. In addition, follow-up urine cultures are generally recommended within 10 to 14 days after treatment. Not all of the antibiotics approved for uncomplicated UTIs are appropriate for the complicated version. Some that are considered appropriate, include:

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Antibiotic Treatments For Urinary Tract Infections Are Commonly Prescribed To Pregnant Women

Some antibiotic treatments for urinary tract infections , such as nitrofurantoin and trimethoprim-sulfamethoxazole, have been linked to birth defects. The American College of Obstetricians and Gynecologists recommends avoiding these antibiotic treatments in early pregnancy if possible. A study from the Centers for Disease Control and Prevention found thatabout 4 in 10 women with UTIs during early pregnancy filled a prescription for nitrofurantoin or trimethoprim-sulfamethoxazole. Healthcare providers of various specialties should be familiar with ACOGs recommendations about prescribing specific antibiotics to pregnant women and consider the possibility of early pregnancy when treating women of reproductive age. To help determine treatment options, women should inform all of their healthcare providers if they are pregnant or are planning to become pregnant.

Read the full scientific article.

How Are Utis Treated And Prevented

Can antibiotics for a UTI delay ovulation or a period?

A UTI is often a once-off illness that resolves quickly and responds to treatment with antibiotics if needed. However, for some people, UTIs are a recurring problem.

If you have repeated UTIs there are some self-help measures that may help prevent further infections:

  • drink more fluids to help flush out bacteria
  • urinate immediately after intercourse
  • gently wipe from front to back after urinating
  • wear cotton underwear and loose-fitting pants
  • eat natural yoghurt to restore normal vaginal environment
  • find an alternative method of birth control if you use spermicides

There is conflicting evidence for drinking cranberry juice to prevent UTIs. If you want to try cranberry products, ask your doctor for advice.

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Can Sex Make A Uti Worse

If you already have a UTI, having sex can make the infection feel worse, exacerbating the symptoms. Using spermicides can increase discomfort because it can cause irritation. Using non-lubricated latex condoms can also increase friction leading to irritation. Using a water-based lubricant or lubricated condoms will help avoid making your UTI feel more irritated. After and before sex, be sure to urinate immediately to flush out the bacteria.

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Diet For Urinary Incontinence

People suffering from incontinence should try to stick to a more natural diet, filled with natural antioxidants and vitamins, including fruits and vegetables, and water. Everything is balance is recommended for these patients to avoid the worst situations. Certain things are common in everyones diet and without getting notices heavily contribute to incontinence.

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First: What Is A Uti Exactlyand How Do You Usually Treat One

Essentially a UTI is a bacterial infection that can form in your urethra, bladder, or kidneys, causing unpleasant symptoms like frequent urination, a burning sensation while you pee, pelvic pain, and more.

When UTI symptoms rear their ugly head, trying to treat them yourself will only give the infection more time to spread. The longer you wait to get medical attention, the more youre putting yourself at risk for more serious health complications.

One in five women gets a UTI at least once in her life, according to the National Kidney Foundation.

Waiting too long to start treatment can allow the infection to progress from a simple bladder infection treated with three days of oral antibiotics to a complex kidney infection requiring intravenous antibiotics, says Ekene Enemchukwu, MD, assistant professor of urology at Stanford University School of Medicine.

Dr. Enemchukwu also points out that theres also the chance youre actually not dealing with a UTI at allanother reason to always check in with your health care provider about any concerning symptoms. UTI-like symptoms, in the absence of bacteria, can be caused by other conditions, such as vaginal infections, STDs, kidney stones, severe constipation, and vaginal atrophy, says Dr. Enemchukwu.

If its a typical, mild UTI, heres what your treatment will look like. These interventions can also make it easier for you to go about your day and sleep with a UTI.

Treatment Strategies For Recurrent Utis

Antibiotics recommended for the treatment of urinary tract infections ...

Recurrent urinary tract infections, defined as three or more UTIs within 12 months, or two or more occurrences within six months, is very common among women these but arent treated exactly the same as standalone UTIs. One of the reasons: Continued intermittent courses of antibiotics are associated with allergic reactions, organ toxicities, future infection with resistant organisms, and more.

Because of this, its strongly recommended that you receive both a urinalysis and urine culture from your healthcare provider prior to initiating treatment. Once the results are in, the American Urological Association suggests that healthcare professionals do the following:

  • Use first-line treatments. Nitrofurantoin, TMP-SMX, and fosfomycin are the initial go-tos. However, specific drug recommendations should be dependent on the local antibiogram. An antibiogram is a periodic summary of antimicrobial susceptibilities that helps track drug resistance trends.
  • Repeat testing. If UTI symptoms persist after antimicrobial therapy, clinicians should repeat the urinalysis, urine culture, and antibiotic susceptibility testing to help guide further management.
  • Try vaginal estrogen. For peri- and post-menopausal women with recurrent UTIs, vaginal estrogen therapy is recommended to reduce risk of future UTIs.

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