Cystitis uncomplicated

Bacteriuria, or bacteria in the urine, does not always represent infection. For this reason a number of quantitative diagnostic criteria have been created to identify the amount of bacteria in the urine that most likely represents true infection (hence the term significant bacteriuria ). These are shown in Table 76-1. Furthermore, UTIs are classified as lower tract or upper tract disease. Patients will present differently with upper versus lower tract disease, and upper tract disease is thought of as a much more severe infection, as patients are more likely to be admitted to the hospital with upper urinary tract disease than lower tract disease. An example of lower tract infection is cystitis. Cystitis refers to the syndrome associated with a UTI involving dysuria, frequency, urgency, and occasional suprapubic tenderness. An example of upper urinary tract disease is pyelonephritis. Pyelonephritis is an inflammation of the kidney usually due to infection. Frequently, patients with uncomplicated UTI are treated as outpatients, while those patients with complicated UTIs are treated as inpatients. 

Warren JW, Abrutyn E, Hebei JR, et al. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis. Clin Infect Dis 1999 29 745-758. 

The therapeutic management of UTIs is best accomplished by first categorizing the type of infection acute uncomplicated cystitis, symptomatic abacteriuria, asymptomatic bacteriuria, complicated UTIs, recurrent infections, or prostatitis. 

Acute uncomplicated cystitis Escherichia coli Staphylococcus saprophyticus 1. Trimethoprim-sulfamethoxazole x 3 days (A, 1)° 2 Fluoroquinolone x 3 days (A II)0 3. Nitrofurantion x 7 days (B, l)° 4. /)Lactams x 3 days (E, III)0 Short-course therapy more effective than single dose /J-factams as a group are not as effective in acute cystitis than trimethoprim-sulfamethoxazole or the fluoroquinolones0... 

Urinary tract infections - For uncomplicated lower urinary tract infection (eg, cystitis), the usual dosage is 1 or 2 g/day in single or 2 divided doses. For all other urinary tract infections, the usual dosage is 2 g/day in 2 divided doses. 

Streptococcal pharyngitis, skin and skin structure infections, uncomplicated cystitis In patients older than 15 years of age 500 mg every 12 hours. 

Urinary tract infections Urinary tract infections (complicated and uncomplicated), including pyelonephritis and cystitis (initial and recurrent) caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella oxytoca, Citrobacter sp., and Serratia marcescens. 

Urinary tract Uncomplicated cystitis 400 once daily 10 days... 

Nitrofurantoin monohydrate/macrocrystals is indicated only for the treatment of acute uncomplicated UTIs (acute cystitis) caused by susceptible strains of E. coli or Staphylococcus saprophyticus in patients 12 years of age and older. 

Lower tract infections include cystitis (bladder), urethritis (urethra), prostatitis (prostate gland), and epididymitis. Upper tract infections (such as pyelonephritis) involve the kidney and are referred to as pyelonephritis. Uncomplicated UTIs are not associated with structural or neurologic abnormalities that may interfere with the normal flow of urine or the voiding mechanism. Complicated UTIs are the result of a predisposing lesion of the urinary tract such as a congenital abnormality or distortion of the urinary tract, a stone, indwelling catheter, prostatic hypertrophy, obstruction, or neurologic deficit that interferes with the normal flow of urine and urinary tract defenses. 

Urinary tract infections can be classified by anatomic site of involvement into lower and upper urinary tract infections. Lower UTls include cystitis, urethritis, prostatitis, and epididymitis, whereas upper urinary tract infections include pyelonephritis. UTls also may be further classified as complicated or uncomplicated. In females with a structurally normal urinary tract, both cystitis and pyelonephritis are considered uncomplicated UTls. UTls in men, elderly individuals, pregnant women, or patients with in-dwelling... 

Naber KG. Treatment options for acute uncomplicated cystitis in adults. J Antimicrob Chemother 2000 46(suppl Sl) 23—27. 

Ciprofloxacin is a fluoroquinolone antibiotic that interferes with microbial DNA synthesis. It is indicated in the treatment of infections of the lower respiratory tract, skin and skin structure, bones and joints, urinary tract gonorrhea, chancroid, and infectious diarrhea caused by susceptible strains of specific organisms typhoid fever uncomplicated cervical and urethral gonorrhea women with acute uncomplicated cystitis acute sinusitis nosocomial pneumonia chronic bacterial prostatitis complicated intra-abdominal infections reduction of incidence or progression of inhalational anthrax following exposure to aerosolized Bacillus anthracis. Cipro IV Used for empirical therapy for febrile neutropenic patients. 

Loracarbef, a synthetic beta lactam antibiotic of the car-bacephem class (200 to 400 mg p.o. q. 12 hours), is used in the treatment of secondary bacterial infections of acute bronchitis, acute bacterial exacerbations or chronic bronchitis, of pneumonia, pharyngitis, tonsillitis, sinusitis, acute otitis media, uncomplicated skin and skin-structure infections, impetigo, uncomplicated cystitis, and in uncomplicated pyelonephritis. 

Ofloxacin interferes with microbial DNA synthesis. It is indicated in the treatment of acnte bacterial exacerbations of chronic bronchitis, commnnity acquired pneumonia, uncomplicated skin and skin structure infections, acute uncomplicated urethral and cervical gonorrhea, nongonococcal urethritis, cervicitis, acute pelvic inflammatory disease, uncomplicated cystitis, complicated urinary tract infections (UTI), and prostatitis cdiV eAhy Escherichia coli. Ophthalmic use for treatment of conjunctivitis and corneal ulcer infections caused by susceptible organisms otic use for treatment of otitis externa, chronic suppurative otitis media in patients with perforated tympanic membranes, and acute otitis media in pediatric patients with tympanostomy tubes. 

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