Table 1:
Classification of urinary tract infections, symptoms, host risk factors and treatment. [Au: would it work to set the table up as indicated?]
Infection type | Cystitis (bladder infection) | Pyelonephritis (kidney infection) |
---|---|---|
Classification | Uncomplicated UTI Complicated UTI |
Complicated UTI |
Symptoms | - Painful urination (dysuria) - Urinary frequency - Urinary urgency - Suprapubic pain - Bloody urine (hematuria) |
- Fever - Flank pain - Costovertebral angle tenderness |
Host risk factors | - Positive individual UTI history - Positive family history - Sexual activity - New sexual partner - Postmenopausal age - Vaginal dysbiosis - Recent antibiotic use |
- Positive individual UTI history - Positive family history - Sexual activity - New sexual partner - Postmenopausal age - Vaginal dysbiosis - Recent antibiotic use - Anatomic urogenital abnormalities - Vesicoureteral reflux - Diabetes mellitus - Pregnancy - Catheterization - Urolithiasis - Immunosuppression - History of pyelonephritis |
Diagnosis | - Positive urine culture - Pyuria - Hematuria* |
- Positive urine culture - Pyuria - Hematuria* |
Treatment (low MDR risk**) | Empiric treatment with nitrofurantoin or fosfomycin | Treatment with ciprofloxacin or levofloxacin |
Treatment (high MDR risk**) | Treatment with oral β-lactams and fluoroquinolones until culture sensitivity results are acquired | Treatment with ceftriaxone or ertapenem and trimethoprim-sulfamethoxazole, Augmentin or a 3rd-generation cephalosporin |
MDR, multi-drug resistant; UTI, urinary tract infection.
Diagnosis and treatment of acute simple cystitis is often alone, although symptoms are not considered diagnostic.
MDR risk factors include an extended stay at a hospital facility, recent travel to India, Israel, Spain and Mexico, and/or recent antibiotic use.