Urinary tract infection

• Published in: Medicine (Abingdon. 1995, UK ed.) UK ed.), 2023-04, Vol.51 (4), p.239-243
• Main Authors: Glover, Emily K., Sheerin, Neil S.
• Format: Article
• Language: English
• Subjects: Antibiotics; cystitis; host defence; MRCP; pyelonephritis; urinary tract infection
• ISSN: 1357-3039; 1878-9390
• DOI: 10.1016/j.mpmed.2023.01.002

Urinary tract infection is one of the most common infections affecting humans. Uncomplicated infections most commonly occur in otherwise healthy women when uropathogenic bacteria, usually Escherichia coli, enter the bladder and overcome the host's innate immunity. Complicated infections occur in individuals with an anatomical or functional abnormality of the urinary tract. Diagnosis is made on the basis of symptoms, and diagnostic precision is improved by urinalysis. Urine culture is important in individuals with severe, recurrent or complicated infection and when the diagnosis is uncertain, for example in children and elderly people. Most women with symptoms that resolve quickly do not require further investigation, but imaging of the renal tract, functional testing and cystoscopy should be considered in children, men and patients with recurrent or severe infection. Empirical antibiotic treatment started on the basis of symptoms and directed by urinalysis is suitable for uncomplicated cystitis but should be altered based on culture results for more severe infections. Three days of antibiotic treatment is usually sufficient for uncomplicated cystitis in women. Long-term or post-coital antibiotics are effective for patients with recurrent infection.