Urinary Tract Infection
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Urinary Tract Infections (UTIs)
More than 50% of women will have a UTI in their lifetime! About 3-5% will experience recurrent UTIs.
Most Common Causes:
- E. coli – Found in 50-80% of cases
- Staphylococcus saprophyticus – Found in 10-15% of cases
Risk Factors for UTIs
Sexual activity (new partners, spermicide, condoms with spermicide) Postmenopausal changes (weakened bladder function)
Catheter use (increases risk of infection)
Family history of UTIs
Certain medical conditions (diabetes, kidney disease, weakened immune system)
Uncomplicated vs. Complicated UTIs
Uncomplicated UTIs (Simple Cystitis)
Common in healthy, premenopausal women with no major health conditions.
Symptoms: Burning with urination, frequent urges to go, cloudy or smelly urine.
Treatment:
- Nitrofurantoin (Macrobid) 100 mg BID x 5-7 days
- Trimethoprim-Sulfamethoxazole (TMP-SMX) BID x 3 days
- Fosfomycin (Monurol) single dose
Complicated UTIs (Severe or lasting >7 days)
Includes hospital-acquired infections, pregnancy, immune issues, or urinary blockages.
Symptoms: Same as simple UTI but with fever, chills, back pain, or nausea.
Treatment:
- Ciprofloxacin 500 mg BID x 7-14 days
- Levofloxacin 750 mg QD x 7-14 days
- IV antibiotics for severe cases
Kidney Infection (Pyelonephritis)
A UTI that spreads to the kidneys is serious! Symptoms: Fever, back pain, nausea, chills Treatment:
- One dose IV antibiotic (Ciprofloxacin, Ceftriaxone, or Aminoglycoside)
- Followed by oral Ciprofloxacin, Levofloxacin, or TMP-SMX
- Severe cases require hospitalization with IV antibiotics
Recurrent UTIs (More than 2 in 6 months OR 3 in 1 year)
How to Reduce Risk: Drink more water (at least 1.5L daily) Vaginal estrogen (for postmenopausal women) Probiotics, D-mannose, & cranberry products (may help prevent UTIs but need more research!)
Antibiotic Prevention Strategies:
- Post-sex antibiotic (if UTIs are linked to intercourse)
- Self-start therapy (treat at first sign of UTI)
- Low-dose daily antibiotics (for severe cases) Most common preventive antibiotics: Nitrofurantoin, TMP-SMX, Cephalexin
Takeaway: Stay Ahead of UTIs!
Avoid unnecessary antibiotics to prevent resistance. Stay hydrated, practice good hygiene, and seek medical help if UTIs keep coming back!
Your bladder health matters—take care of it!
Urinary Tract Infections (UTIs) in Pregnancy
8% of pregnant women will experience a UTI! Can increase risk of preterm birth & low birth weight.
Most Common Bacteria:
- E. coli (70-90%)
- Other culprits: Klebsiella, Proteus, Enterococci, Staph, Group B Strep (GBS)
Why Are Pregnant Women at Higher Risk?
- Hormonal changes (progesterone relaxes bladder muscles)
- Growing uterus presses on bladder, causing urine buildup
- Higher chance of bacteria moving up into the urinary tract
Asymptomatic Bacteriuria (ASB) (2-10% of pregnancies)
No symptoms, but bacteria present in urine! ✔️ Screening: Urine culture early in pregnancy. ✔️ Treatment: 5-7 days of antibiotics if 100,000 CFU/mL or higher. ✔️ GBS present? Only treat if 100,000 CFU/mL or more, otherwise just note for delivery precautions.
Acute Cystitis (Bladder Infection) (1-2% of pregnancies)
✔️ Symptoms: Urgency, burning, frequent urination, suprapubic pain, possible blood in urine. ✔️ Testing:
- Urinalysis (U/A): +Nitrites (most specific), +Leukocyte esterase, pyuria (WBCs in urine)
- Urine Culture (UCx): Confirms infection with 100,000 CFU/mL, but treatment may begin at 1,000 CFU/mL if symptoms are present. ✔️ Treatment: 5-7 days of antibiotics (avoid amoxicillin due to resistance!).
Safe Antibiotics for UTIs in Pregnancy
| Antibiotic | Dosage | Notes |
|---|---|---|
| Nitrofurantoin (Macrobid) | 100mg BID x 5-7 days | Avoid after 38 weeks (risk of newborn anemia). Not for kidney infections. |
| Cephalexin (Keflex) | 250-500mg QID x 5-7 days | Generally safe. |
| TMP-SMX (Bactrim) | 800/160mg BID x 5-7 days | Avoid in 1st & 3rd trimester. |
| Fosfomycin | 3g x 1 dose | Single-dose option but not for kidney infections. |
| Amoxicillin | 500mg TID x 5-7 days | High resistance—wait for culture results. |
| Amoxicillin-Clavulanate (Augmentin) | 500mg TID x 5-7 days | Similar to amoxicillin—use culture results. |
Recurrent UTIs in Pregnancy (>2 in 6 months or >3 in 1 year)
Happens in 4-5% of pregnancies! Prevention Strategies:
- Post-sex antibiotics (if linked to intercourse)
- Daily suppressive antibiotics:
- Macrobid 100mg QD or Keflex 250-500mg QD
Takeaway: Protect Your Bladder & Baby!
- Get tested early & treat infections quickly.
- Stay hydrated & practice good hygiene.
- If you have frequent UTIs, talk to your doctor about prevention!