Urinary Tract Infections (UTIs)

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Last Medical Review: March 26, 2020
Medically Reviewed by Dr. David Costa Navarro
Urinary tract infections (UTIs) (March 26, 2020)

What are urinary tract infections?

Lower urinary tract infections (e.g. cystitis and urethritis) are a rather common infectious problem, which is responsible for normally saprophytic bacteria of the intestine and external genitalia (Escherichia Coli, responsible for over 75% of cases, and other bacteria, such as Staphylococcus saprofiticus, Proteus Mirabilis, Klebsiella). These microorganisms, under certain conditions, can colonize the urinary tract up to, through the urethra, the bladder.

Who are the most frequently affected individuals?

Lower urinary tract infections are 50 times more frequent in sexually active women between the ages of 20 and 50 than the rest of the population. The reason is to be found in the shortness of the female urethra and in the proximity of the genital and anal orifices, which translates into a greater possibility of contamination by germs of intestinal origin. In some cases a recurring form may develop. It is believed that, in women, in addition to the presence of predisposing factors such as the use of the diaphragm and a high vaginal pH, recurrent infections may also be due to the absence of some local defense mechanisms. Among men, those with problems of urinary obstruction of prostatic origin and the elderly are at greater risk of infections of the urinary tract.

What are the symptoms?

The characteristic symptom is the urgent need to urinate, with urination (the elimination of urine) divided into frequent short acts (pollakiuria) and often painful and difficult (dysuria). Urine may be cloudy due to the presence of pus and may show traces of blood.

What should be done?

Cystitis is a superficial infection with a benign course provided it is treated effectively. As a general rule it is advisable to drink a lot of water throughout the day, possibly with the addition of a tip of sodium bicarbonate or sodium citrate (eg Citrosodine), to decrease the acidity of the urine and reduce the bacterial load of the infectious microorganisms; with these simple measures, symptoms can sometimes disappear even without any therapy. Treatment must be prescribed by the doctor; the most used drugs are co-trimoxazole (eg Bactrim) and nitrofurantoin (eg Neofuradantin) usually taken for 3 days (but they have also been effective after a single administration); ciprofloxacin (eg Ciproxin) is used mainly in cases of recurrent infections or previous therapeutic failures. Men typically require more protracted treatment.

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