Urinary tract infections (UTIs) are common infections that affect the urinary system, including the bladder, urethra, and kidneys. In this article, we will explore the different types of UTIs, their management strategies, and red flag signs that require immediate attention.

Acute Cystitis/Simple UTI:

Treatment duration: Men should be treated for 7 days.

Recommended antibiotics:

Nitrofurantoin* 100 mg PO twice daily for 7 days.

TMP/SMX 1 DS tablet PO twice daily for 7 days.

Ciprofloxacin 500 mg twice daily for 7 days.

Levofloxacin 750 mg once daily for 5 days.

Acute cystitis in males does not require referral.

Refer cases involving:

Pyelonephritis or complicated UTIs.

Pelvic/perineal pain (prostatitis).

Cystitis/UTI:

Empirical Treatment (based on symptoms, no tests needed):

Nitrofurantoin* 100 mg PO twice daily for 5 days.

TMP/SMX 1 DS tablet PO twice daily for 3 days.

If no response to empirical treatment, refer to a higher center.

Pyelonephritis and Complicated UTIs:

Refer cases of pyelonephritis and complicated UTIs.

Red Flag Signs Requiring Referral:

The following red flag signs indicate the need for immediate referral:

Special situations: Children, pregnancy, males (except simple cystitis), and catheter-associated UTIs.

Non-response to antibiotic treatment within 3 days.

Recurrent UTIs.

Send a urine sample for culture.

Consider imaging if no response to antibiotics within 48 hours.

Urology services should be involved if there is an obstruction.

For children presenting with their first UTI, the following evaluations are recommended based on age:

Age <1 year:

Ultrasound.

Micturating cystourethrogram (MCU).

DMSA renal scan.

Age 1-5 years:

Ultrasound.

DMSA scan.

MCU if ultrasound or DMSA scan is abnormal.

Age >5 years:

Ultrasound.

MCU and DMSA scan if the ultrasound is abnormal.

Additionally, all patients with recurrent UTIs should undergo a detailed evaluation, including ultrasonography, DMSA scan, and MCU.

Urinary tract infections can cause discomfort and complications if left untreated. Proper management and timely identification of red flag signs are crucial in ensuring effective treatment and preventing further complications. It is important to follow the recommended treatment guidelines and seek medical attention if there are any concerns or if symptoms persist. By understanding the different types of UTIs and their appropriate management, individuals can take control of their urinary health and well-being.