Urinary Tract Infection (UTI)

Clinical Features:

• 1)Pain or burning while urinating.
• 2)Frequent urination.
• 3)Feeling the need to urinate despite having an empty bladder.
• 4)Bloody urine.
• 5)Pressure or cramping in the groin or lower abdomen.

On Examination:

• BP
• Pulse 
• Anaemia
• Temperature-increase
• Supra-pubic tenderness- cystitis (lower UTI)
• Renal angle tenderness- Pylonephritis (upper UTI)

INVESTIGATIONS:

• 1)Urine RME - pus cell,epithelial cell ,RBC (must present ,without RBC no UTI)
• 2)Serum creatinine 
• 3)CBC
• 4)USG of KUB- To cystitis & pylonephritis
• 5)X-ray KUB
• 6)Urine C/S- To antibiotic sensitivity & organism 

Rx:

• Diet : Normal (if severe pain then NPO)
• Plenty of water intake 
• Inf.5%(post id="510" title="DNS"]))(1L) ..I/V @ 20 d/min 
• Inj.Cefotil ([post id="400" title="Cefuroxime"]) 750mg ....1 vial I/V stat ....BD 
• Inj. Pantonix ([post id="393" title="Pantoprazole"])(40mg) ...1 ampl ..I/V stat & BD 

If Pain:

• Inj. Viset([post id="451" title="Tiemonium"]) 50mg .....1 ample ..I/V stat .& TDS (mild pain) 
• Inj.Anadol ([post id="453" title="Tramadol"])(100mg) ..1ample...I/V stat & Sos (severe pain)

If Vomiting:

• Inj.Emistat ([post id="509" title="ondansetron"])(8mg) ....1 amp ..I/V stat & sos 

If Fever

• Tab . Napa([post id="449" title="Paracetamol"]) (500mg) ..1+1+1 
• Napa([post id="449" title="Paracetamol"]) suppository 500mg...P\R stat & sos (if tem >101°F) 

If Dysuria : 

• Syp.Potacit/Urikal 1-2 tsf mixed with 1/2 glass water - 2/3 times daily...7 days 

Recurrrent :

• Cap. Umactin(Nitrofurantoin) BD (100mg)
• 1+0+1…..14 days

Reccurent UTI but no cause find:

• Cap. Umactin (100 mg)
• 1+0+1( 3 Consusecutive days per week) .... contine
  

উপদেশ:

•  প্রতিদিন কমপক্ষে ২-৩ লিটার পানি খাবেন।
  
• প্রসাবের চাপ ধরে রাখবেন না। চাপ আসলেই প্রস্রাব করবেন।
  
• সহবাসের পূর্বে ও পরে প্রসাব করবেন।
  
•  মাসিকের সময় পরিস্কার কাপড়/স্যানিটারী প্যাড ব্যবহার করবেন।
  
•  পানি খরচের সময় বাম হাত সামনে থেকে পিছনে নিয়ে যাবেন।পিছন থেকে সামনে আনবেন না।

Chamber / outdoor Mx UTI:

Rx: 

• Tab.Napa([post id="449" title="Paracetamol"])
  
• 1+1+1......3 days(if fever)
• Tab.Ceevit (250mg)
• 1+0+1.......10 days (collagen synthesis)

• Tab.Viset ([post id="451" title="Tiemonium"](50mg))
  
• 1+1+1.....3-5 days
• Syp.Potacit/Urikal 
• 1-2 tsf mixed with 1/2 glass water - 2/3 times daily...7 days 
• Cap.Pantonix (20mg)
• 1+0+1..........10 days 

Choice of Antibiotics :

Cystitis: 

1st drug of choice: 

• Cap.Umactin (Nitrofurantoin)(50mg)

• 1+1+1+1.....7-10 days

OR

• Cap.Umactin(Nitrofurantoin)(100mg)
• 1+0+1....7-10 days

2nd line drug: 

• Tab.Ciprocin([post id="408" title="Ciprofloxacin"]) (500mg) 
• 1+0+1............7-10 days

Cystitis in Pregnancy:

• Cap.Umactin (Nitrofurantoin)(100mg)
• 1+0+1.......7 days

OR 

• Cap.Neorex(cephalexin)(250mg) 
• 1+1+1+1........7 days

Prophylaxis therapy for UTI:

• Cap.Umactin (Nitrofurantoin)(50mg)
• At night .......continue

OR 

• Tab.Trimethoprim(100mg) 
• At night........continious 

Pylonephritis:

1st line drug  : 

• Tab.Ciprocin([post id="408" title="Ciprofloxacin"]) (500mg) 
• 1+0+1...........14 days

2nd Line drug:

• Tab.Furotil([post id="400" title="Cefuroxime"]) (500mg)
• 1+0+1..........14 days

Epididymo-orchitis & Acute Prostatitis :

• Tab.Ciprocin ([post id="408" title="Ciprofloxacin"])(500mg) 
• 1+0+1............14 days