Urinary tract infection pregnancy

From a therapeutic point of view, it is essential to confirm the presence of bacteriuria (a condition in which there are bacteria in the urine) since symptoms alone are not a reliable method of documenting infection. This applies particularly to bladder infection where the symptoms of burning micturition (dysuria) and frequency can be associated with a variety of non-bacteriuric conditions. Patients with symptomatic bacteriuria should always be treated. However, the necessity to treat asymptomatic bacteriuric patients varies with age and the presence or absence of underlying urinary tract abnormalities. In the pre-school child it is essential to treat all urinary tract infections and maintain the urine in a sterile state so that normal kidney maturation can proceed. Likewise in pregnancy there is a risk of infection ascending from the bladder to involve the kidney. This is a serious complication and may result in premature labour. Other indications for treating asymptomatic bacteriuria include the presence of underlying renal abnormalities such as stones which may be associated with repeated infections caused by Proteus spp. 

Women with SCT also can have frequent urinary tract infections, especially during pregnancy. 

Christensen B. Which antibiotics are appropriate for treating bacteriuria in pregnancy. J Antimicrob Chemother 2000 46(Suppl Sl) 29—34. Finn SD. Acute uncomplicated urinary tract infections. Med Clin North Am 1997 81 719-729. 

Elderly Advanced age was associated with a decrease of tiotropium renal clearance, which may be explained by decreased renal function. In the placebo-controlled studies, a higher frequency of dry mouth, constipation, and urinary tract infections was observed with increasing age in the tiotropium group. Pregnancy Category C. 

Fosfomycin is approved for use as a single 3-g dose for treatment of uncomplicated lower urinary tract infections in women. The drug appears to be safe for use in pregnancy. 

Case study level 2 - Urinary tract infections in pregnancy... 

Case study level 1 - Primary dysmenorrhoea 150 Case study level 2 - Urinary tract infections in pregnancy 151 Case study level 3 - Pelvic inflammatory disease 152 Case study level Ma - Endometriosis management in secondary care 154... 

Delzell JE, Lefevre ML. Urinary tract infections during pregnancy. Am Fam Phys 2000 61 713-721. 

Andriole VT, Patterson TF. Epidemiology, natural history, and management of urinary tract infection in pregnancy. Med Chn North Am... 

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