# *** Uncomplicated/Complicated Urinary Tract Infection
-- Onset: ***
-- Symptoms: *** frequency, urgency, dysuria, incontinence, nocturia, suprapubic tenderness, hematuria; if discharge, vaginitis, consider STI as well
-- Red Flags: *** prior MDRO UTI, fevers/chills, n/v, flank pain, male, c/f obstruction, immunocompromised, renal transplant, indwelling catheter - all make UTI “complicated”
-- Sexual Hx: *** pregnancy, recent partners, protection, hx of STI
-- Previous UTI: ***
-- DDx: *** vaginitis, urethritis, PID, nephrolithiasis, interstitial cystitis, drug or radiation cystitis
-- Abx: ***
-- Send pregnancy test if possibly pregnant
-- Send UA or UCx if elderly, complicated, treatment not working after 2-3 days, or recurrent within last 3 months
-- Consider sending UTI testing (chlamydia and gonorrhea)
-- Consider PPx with Bactrim or cephalexin if recurrence (>=2 episodes in 6 months or >=3 in a year); also topical estrogen if post-menopausal, methenamine hippurate with vitamin C
-- Refer: send to the ED/hospital if systemic symptoms concerning for pyelo or sepsis (UTIs are the most common infection leading to septic shock) inability to take PO meds, immunocompromised
Template coming soon!
Uncomplicated UTI Treatment
Based on your history and symptoms, you likely have a urinary tract infection (UTI).
You should take *** for ***. We will need to have a urine pregnancy test done beforehand.
Please let us know if your symptoms do not get better in the next 2-3 days, or if you develop fevers, nausea/vomiting, or abdominal/flank pain which can indicate a worsening UTI involving your kidneys.
In general, to avoid UTIs, avoid using douching products, be sure to drink plenty of fluids (2-3L per day), and urinate shortly after sexual activity.
UTIs (specifically acute cystitis) are common and many can be treated just based on clinical story. Avoid nitrofurantoin if the patient may be pregnant. Common abx for ucomplicated UTIs include Bactrim DS BID 3 days, nitrofurantoin 100mg BID 5 days, cefpodoxime 200mg BID 7 days. If the UTI is complicated (prior MDRO UTI, fevers/chills, n/v, flank pain, male, c/f obstruction, immunocompromised, renal transplant, indwelling catheter) or there is concern for treatment failure after 2-3 days, they should be seen in clinic and have UA/UCx sent. If there is concern for pyelonephritis or sepsis, they should be sent to the ED.