Urinary tract infection in women symptoms

Characteristics of the disease

Urinary tract infection in women as well as men is a common problem in clinical practice. Urinary tract infections most often are a manifestation of acute bacterial cystitis or acute urethral syndrome.

Treatment of urinary tract infections, mainly submitted to chemotherapeutic treatment that is characterized by high pharmacokinetic properties and low side effects. The most commonly used drugs are Fluoroquinolones, Cotrimoxazole, beta-lactam antibiotics, Nitrofurantoin and Fosfomycin – Trometamol.

The most common complication is recurrent female cystitis. This indication is a common long-term positive effect of prophylactic administration of low doses of chemotherapeutic agents in recent years is introduced and immunotherapy.

Infection of the urinary system is one of the most common problems in clinical medicine. From the point of view of severity of the disease, it represents a wide range of conditions from asymptomatic bacteriuria, on the one hand, to life-threatening acute pyelonephritis with septicemia, on the other hand. It is believed that the majority of women is striking, at least one infectious disease of the urinary tract in life. Various sources indicate that only 2-10% of women who tend to have recurrent symptomatic recurrent infection of the bladder and urethra. This is a chronic infection. The frequency of bacteriuria and urinary tract infections in men more than it affects older age groups and also determined by various complications (benign prostatic hyperplasia with obstruction, the institution of a urinary catheter, etc.).

The majority of infections is caused by bacteria belonging to the family Enterobacteriaceae (usually E. coli) that colonize the distal urethra and, subsequently, urinary tract.

Urinary tract infection – treatment and symptoms

Selection of the optimal mode of treatment and selection of chemotherapeutic agents depends on the nature of the disease (symptomatic or asymptomatic), the state of the urinary system (the presence or absence of complicating factors, renal disease), location (localization) lesions (pyelonephritis, zestoretic, prostatitis, etc.).

Urinary tract infection – symptoms

The so-called simple urinary tract infections are present in individuals with structurally and functionally normal urinary tract. Complicated infections are those that occur in people with structural or functional urinary tract disorders or the presence of severe General diseases that contribute to the development of infection (diabetes, transplantation, immunodeficiency, etc.) From a therapeutic point of view, urinary tract infections are divided into the following clinical categories::

1. Uncomplicated acute urinary tract infections (acute cystitis).
2. Acute uncomplicated pyelonephritis.
3. Complicated urinary tract infections.
4. Specific forms of urinary tract infections.

For distinction, generally used clinical criteria:

1. Pyelonephritis is characterized by the overall complexity of symptoms: fever, chills, lower back pain or weakness. Some experts believe that fever above 38°C is the most reliable criterion to determine the infectious lesions of the kidneys and upper urinary tract. Fever indicates bacteremia. May be present nausea, vomiting, diarrhea.
2. Infections of the lower urinary tract – clinical criteria cystitis difficult to distinguish from acute urethral syndrome. As a rule,appear dizuricheskie disorders (tingling, burning during urination), compulsive increase in the frequency of urination, suprapubic pain, pressure or feeling of fullness. Fever does not occur.

Therapy urinary tract infections treatment of acute bacterial cystitis

Given the fact that acute bacterial cystitis is an inflammation of the mucous membrane of the bladder, for the success of treatment plays a decisive role to achieve concentrations of antibacterial drugs in the urine. Preferably used drugs which are mainly excreted by the kidneys, and long reach high levels in the urine, and have favorable pharmacokinetic abilities. In this regard, it is particularly important:

• The ability of chemotherapy to destroy the causative agent of the disease in the urinary tract.
• The ability of chemotherapy to eliminate clinical signs of infection.
• The ability of chemotherapeutic agents to prevent recurrences and reinfection.
• The problem of selection of resistant bacterial strains.
• Side effects of used medications and their severity.
• Pharmacoeconomic aspects of the treatment.

In this category of uncomplicated lower urinary tract infections, which also includes acute cystitis, there is complete agreement of the experts concerning the effectiveness, feasibility and safety of short-term regimens (3-day or single treatment with a single therapeutic dose of the right drug).

How to treat a urinary tract infection

The medications that have proven effective in the short-term treatment, are those which satisfy the following requirements:

Cotrimoxazole

In the treatment of urinary tract this drug has been used for many years. As a combined drug (Trimethoprim-Sulfamethoxazole), despite the increase in resistance, it is relatively well tolerated in the treatment of bacterial cystitis.

With repeated and prolonged use increases the frequency of bacterial resistance and side effects.

Adults are recommended to take 2 times a day 1-2 tablets (480 mg, respectively). Can take Trimethoprim alone in a dose of 200 mg/day.

Ampicillin or Amoxicillin

These drugs belong to the classical and popular antibiotics for this indication. You must exercise the utmost caution before accepting illegible Ampicillin/Amoxicillin in the empiric treatment of infections. In the treatment of acute cystitis are used Aminopenicillin, potentiated by inhibitors of bacterial beta-lactamase:

1. Ampicillin/Sulbactam 375 mg 2 or 3 times a day.
2. Amoxicillin/Clavulanate – 375 or 625 mg 3 times a day.

These drugs are the drugs of first choice, particularly for children, pregnant and nursing mothers, and in the case of urinary tract infections caused by gram-positive cocci (enterococci, staphylococci) bacteria Acinetobacter SPP.

Oral cephalosporins II and the following generations

These drugs include have Aporoximately, Proxetil, Cefetamet Pivoxil, Ceftibuten, Cefixime, etc. They are also extremely effective in the treatment of acute cystitis, characterized bactericidal action on gram-positive and gram-negative bacteria. The advantages are the high levels of drugs in urine, the possibility of treatment of children, women during pregnancy and lactation and a low incidence of side effects.

Today, discussions are held on a higher number of relapses after taking these drugs, especially in cystitis caused by coagulasenegative staphylococci.

Nitrofurantoin

It has good effect against most gram-negative uropathogens. In addition to gram-positive bacteria, the drug has no action on Pseudomonas bacteria and most species of Proteus. The usual therapeutic dose of 200-300 mg/24 h often causes nausea and/or vomiting. In the treatment of acute bacterial cystitis medicine has other limitations:

• insufficient tissue penetration in the prostate and vaginal secretions,
• the drug has no effect on microbial adhesion to epithelial cells,
• the unsuitability of the reception when violation of the kidney or liver, as well as during pregnancy,
• the high increase in resistance with repeated or prolonged use.

The Fosfomycin-Trometamol

Is especially effective chemotherapeutic means for the single treatment of acute cystitis. A single administration of the drug in a number of studies showed a highly significant effect and safety, even during pregnancy.

Complications

The occurrence of frequent recurrence of bacterial cystitis is one of the most common problems of clinical medicine. The possibilities of their treatment are the subject of several clinical studies and monitoring. Although currently indicated a beneficial effect of long-term (6 months-3 years) prophylactic administration of low doses of chemotherapeutic agents, different points of view expressed in relation to selection of appropriate drugs, their dosages, frequency and duration of admission.

Resultsresearch and work published in international literature, confirmed that Pefloxacin 400-800 mg and Fleroxacin 400 mg, injected once a week for 12 months in a long time is an effective and safe method for prolonging chemotherapy, comparable to other proven treatments.

Among other prevention methods have been proven finds its place local application of estrogen vaginal cream in postmenopausal women with recurrent urinary tract infections.

Other possible alternatives

1. Preventive administration of low doses of chemotherapeutic agents on a daily basis (for example, 240 mg Cotrimoxazole, Nitrofurantoin 50-100 mg, Norfloxacin 200 mg) or 3 times a week (Ciprofloxacin 125 mg).
2. Post-coital prophylaxis of sexually active women (e.g., Ciprofloxacin 250 mg). Especially preferred is the process in that case, if the recurrence of cystitis may be associated with previous sexual contact.
3. Immunotherapy.

Acute urethral syndrome

The disease is characterized by clinical symptoms of the lower urinary tract (dysuria), and the absence of significant bacteriuria. The etiology is undoubtedly multifactorial. It was found that some patients have acute bacterial cystitis bacteriuria with 102-104/ml of urine, accompanied by leukocyturia. Pyuria confirms the inflammation of the mucous membrane of the bladder.

The second group consists of patients with chlamydial or mycoplasmal urethritis (caused by chlamydia trachomatis or Ureaplasma urealyticum). If microbiologically confirmed this type of infection, when treatment is indicated Macrolides and Fluoroquinolones, both the patient and his partner. The alternative is Doxycycline.

Differential-diagnostically draws attention to gynecological diseases (bacterial vaginosis, atrophic vaginitis, vaginal candidiasis, etc.) and sexually transmitted infections (gonorrhea, genital herpes, Trichomonas infection, etc.).

Asymptomatic bacteriuria

It is defined by the presence of ≥ 105 CFU/ml of urine is identical of the pathogen in two urine samples taken with a time interval of at least 24 hours. To consider the treatment is necessary in children, during pregnancy, in patients previously undergone urologic procedures, operations and diagnostic procedures, in patients with immunosuppression after transplantation. The question remains regarding treatment of asymptomatic bacteriuria in patients with diabetes mellitus.

Conclusion

Treatment of urinary tract infections only belongs in the hands of a specialist. When the first symptoms consult a doctor. Doctor will not only determine the cause of an adverse condition, but also prescribe therapies that are most effective and safe for you.

Remember that urinary tract infection can be very tricky and dangerous.