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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