Ency. home > Disease > U > Urinary tract infection - chronic or recurrent

Urinary tract infection - chronic or recurrent     See images

Overview | Symptoms | Treatment | Prevention

Alternative names:

UTI - chronic or recurrent

Treatment

Mild cases of acute cystitis may disappear spontaneously without treatment. However, because of the risk of the infection spreading to the kidneys (complicated UTI), treatment is usually recommended. Also, due to the high mortality rate in the elderly population, prompt treatment is recommended.

MEDICATIONS:
Antibiotics may be used to control the bacterial infection. It is imperative that you finish the entire course of prescribed antibiotics. Commonly used antibiotics include:

• nitrofurantoin
• sulfa drugs (sulfonamides)
• amoxicillin
• cephalosporins
• trimethoprim-sulfamethoxazole
• doxycycline

Chronic or recurrent urinary tract infection should be treated thoroughly because of the chance of kidney infection (pyelonephritis). Antibiotics control the bacterial infection. They may need to be given for long periods of time (as long as 6 months to 2 years), or stronger antibiotics may be needed than for single, acute episodes of cystitis. Prophylactic low-dose antibiotics may be recommended after acute symptoms have subsided.

Phenazopyridine hydrochloride (pyridium) may be used to reduce the burning and urgency associated with cystitis. In addition, acidifying medications, such a ascorbic acid may be recommended to decrease the concentration of bacteria in the urine.

SURGERY:
Surgery is generally not needed to treat urinary tract infections.

OTHER THERAPY:
Preventive measures may reduce symptoms and prevent recurrence of infection. Keeping the genital area clean and remembering to wipe from front to back may reduce the chance of dragging bacteria from the rectal area to the urethra.

Urinating immediately after sexual intercourse may help eliminate any bacteria that may have been introduced during intercourse. Refraining from urinating for a long period of time may allow bacteria time to multiply, so frequent urination may reduce the risk of cystitis in those who are prone to urinary tract infections.

DIET:
Increasing the intake of fluids (2000 to 4000 cc per day) encourages frequent urination that flushes the bacteria from the bladder. Avoid fluids that irritate the bladder, such as alcohol, citrus juices, and caffeine.

MONITORING:
Follow-up urine cultures may be necessary to ensure that bacteria are no longer present in the bladder.

Prognosis

Most cases are cured without complication after adequate treatment. The treatment may be prolonged.

Complications

• pyelonephritis
• kidney abscess
• swelling of the kidneys (hydronephrosis)

Call Your Health Care Provider If:

Call for an appointment with your health care provider if symptoms of cystitis persist after treatment, or recur more than 2 times in 6 months.

Call your health care provider if symptoms worsen or new symptoms develop, especially persistent fever, back pain or flank pain, and vomiting.

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