An overview on urinary tract infection in pregnancy

Urinary tract infections (UTI) include a wide range of symptoms, such as urethritis, cystitis, prostatitis, and pyelonephritis. The most frequent bacterial infections are UTIs. Lower and upper UTI’s are used to categories UTI’s. While pyelonephritis is an upper tract infection, cystitis is a lower tract infection. Significant physiologic changes to the entire urinary system occur during pregnancy and drastically influence the prevalence of UTI’s and pyelonephritis. Both symptomatic and asymptomatic forms are possible. Gram-negative bacteria are the most frequent causes of both symptomatic and acute UTI, including E. coli, K. pneumonia, P. areuginosa, Enterobacter, and Serratia. The gold standard for the diagnosis of a urinary tract infection is quantitative culture methods. Untreated UTIs have been linked to severe morbidity and mortality in pregnant women and their babies. According to Edward Kass's groundbreaking research, 6% of pregnant women reported asymptomatic bacteriuria (ASB), which was linked to higher preterm and perinatal death than those with sterile urine. According to the urine culture and sensitivity results, correct treatment is therefore of utmost importance. An agent with a seven-day dosage schedule that is safe for both the mother and the fetus should be used as the therapy. To prevent a recurrence of UTI, confirmation of the pathogenic organism's full eradication is required. Precautions and good cleanliness can also aid in preventing recurrence.

Manejo de las infecciones urinarias en la consulta ambulatoria: de las guías a la práctica clínica / Management of urinary tract infections in the outpatient clinic: from the guides to clinical practice

La infección del tracto urinario constituye el segundo proceso infeccioso más frecuente en el ser humano. Existen controversias respecto a la conducta en casos de bacteriuria asintomática, cistitis aguda no complicada, pielonefritis aguda y manejo de pacientes cateterizados. Objetivo: Con este estudio descriptivo basado en la realización de una encuesta pretendemos comparar el manejo de las infecciones urinarias en la consulta ambulatoria con respecto a las recomendaciones de las guías internacionales. Materiales y Métodos: Se realizó un estudio descriptivo basado en una encuesta compuesta de 15 preguntas de selección múltiple basadas en las guías internacionales dirigida a médicos de familia y de atención primaria de la salud (APS). El análisis estadístico de los datos fue realizado con el programa Microsoft Excel 2003®. Las frecuencias fueron expresadas como porcentajes y los datos cuantitativos como media, mediana y moda. Discusión y Resultados: Existe discordancia en el manejo ambulatorio de las infecciones urinarias de los profesionales encuestados en relación a lo establecido en las guías internacionales. El 48,4% de los médicos utiliza la ciprofloxacina como antibiótico de primera línea para la cistitis aguda no complicada; el 50,8% indica el tratamiento antibiótico durante 6 a 10 días. Con respecto a la resistencia de los uropatógenos, solo el 10% conoce como se encuentra la misma en sus centros hospitalarios. En cuanto al tratamiento de la pielonefritis aguda, el 57% considera necesario el tratamiento parenteral en todos los casos.

The infection of the urinary tract constitutes the second most frequent infectious process in the human being. Controversies exist regarding behavior in cases of asymptomatic bacteriuria, uncomplicated acute cystitis, acute pyelonephritis and management of catheterized patients. Objective: With this descriptive study based on the conduct of a survey, we intend to compare the management of urinary tract infections in the outpatient clinic with respect to the recommendations of international guidelines. Material and method: A descriptive study was conducted based on a survey composed of 15 multiple-choice questions based on international guidelines for family doctors and primary health care (PHC). The statistical analysis of the data was performed with the Microsoft Excel 2003® program. The frequencies were expressed as percentages and the quantitative data such as mean, median and fashion. Discussion and Results: There is disagreement in the ambulatory management of urinary tract infections of the professionals surveyed in relation to what is established in the international guidelines.48.4% of doctors use ciprofloxacin as a first-line antibiotic for uncomplicated acute cystitis; 50.8% indicate antibiotic treatment for 6 to 10 days. With respect to the resistance of uropathogens, only 10% know how it is in their hospital centers. Regarding the treatment of acute pyelonephritis, 57% considered parenteral treatment necessary in all cases.

Use of ofloxacin in treatment of acute cystitis in non-pregnant women.

Fifty non-pregnant women, who were diagnosed as acute cystitis were given ofloxacin (Tarividฎ, 100 mg.), tablets orally twice daily for 7 days. The ages of the patients ranged from 17 to 64 years. After 3 days of treatment, the symptoms and fregvenay of dysuria were almost resolved, pyuria improved, and bacteriuria disappeared. Bacteriological study revealed that the most common organism found was E. coli (34.2 per cent). The other isolated organisms were Staph. epidermidis (21.1 per cent), polymicrobial (18.4 per cent), and Staph. Coagulase (-) (10.6 per cent). No symptoms nor alternations in haematological, renal and hepatic function were observed in the patients during and after completion of medication. Utilizing ofloxacin for the treatment of acute cystitis in non-pregnant women is efficient even with 3 days regimen. It also has no been shown to produce any side-effect.