Urinary Tract Infection : Diagnostic Studies

Diagnostic Studies
- History and physical examination
- Dipstick urinalysis
  - Identify presence of nitrites, WBCs, and leukocyte esterase
- Urine culture
  - Urine for culture and sensitivity (if indicated)
    - Clean-catch sample preferred
    - Specimen by catheterization or suprapubic needle aspiration more accurate
    - Determine bacteria susceptibility to antibiotics
- Imaging studies
  - Ultrasound
  - CT scan (CT urogram)

Drug Therapy
- Antibiotics
  - Selected on empiric therapy or results of sensitivity testing
  - Uncomplicated cystitis
    - Short-term course (typically 3 days)
  - Complicated UTIs
    - Long-term treatment (7 to 14 days or more)
  - Trimethoprim/sulfamethoxazole
  - Used to treat uncomplicated or initial UTI
    - Inexpensive
    - Taken twice a day
  - Nitrofurantoin (Macrodantin)
    - Given three or four times a day
    - Long-acting preparation (Macrobid) is taken twice daily
  - Ampicillin, amoxicillin, cephalosporins
    - Treat uncomplicated UTI
  - Fluoroquinolones
    - Treat complicated UTIs
    - Example: ciprofloxacin (Cipro)
- Antifungals
  - Amphotericin or fluconazole
    - UTIs secondary to fungi
- Urinary analgesic
  - Phenazopyridine
    - Used in combination with antibiotics
    - Provides soothing effect on urinary tract mucosa
    - Stains urine reddish orange
      - Can be mistaken for blood and may stain underclothing

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