Title: Best Practices to Treat Urinary Tract Infections Reviewed
Headings: Best Practices to Treat Urinary Tract Infections Reviewed
Best Practices to Treat Urinary Tract Infections Reviewed
CME/CE
Best Practices to Treat Urinary Tract Infections Reviewed
Urol Nurs. 2008;28:333-341.
Clinical Context
Study Highlights
Pearls for Practice
CME/CE Test
Question 1 of 2
Question 2 of 2

Content: Other interventions may include rest,  hydration, and short-term use of urinary analgesics with agents such as phenazopyridine and urised. Limited data suggest that  cranberry juice or its extract may reduce bacterial adherence and protect against developing cystitis. Patients with complicated UTIs often require more intensive antibiotic therapy, including long-term prophylaxis, postcoital  treatment, or self-start treatment. To prevent progression to pyelonephritis, with its attendant complications and morbidity,  infections associated with transurethral catheterization or pregnancy should be carefully managed. Some frequently prescribed antibiotics often result in harmful changes to normal vaginal flora, with yeast vaginitis occurring  in 25% of patients treated with ampicillin and 80% of those treated with tetracycline. Nitrofurantoin is highly effective against Escherichia coli, gram-positive cocci, and many gram-negative bacteria, and it is well studied and generally well tolerated, with no significant  effects on vaginal flora. However, it is inactive against most Proteus, some Enterobacter, and some Klebsiella, and it must be given for 7 days. Although trimethoprim/sulfamethoxazole can be given twice daily and has only moderate effects on bowel and vaginal flora,  up to 39% of E coli responsible for community-acquired UTIs are resistant to this drug. When given for 3 days, trimethoprim/sulfamethoxazole  is more effective than a 3-day course of nitrofurantoin. Ciprofloxacin and other quinolone derivatives are expensive but are highly effective for gram-negative bacteria and have expanded  coverage against Pseudomonas aeruginosa and gram-positive bacteria.