Urinary Tract Infection

A urinary tract infection (UTI) is an infection of any part of the urinary system, most commonly the bladder, caused predominantly by bacteria ascending from the perineal area. UTIs are more common in women.

• Burning pain on urination (dysuria)
• Increased urinary frequency and urgency
• Lower abdominal or suprapubic pain
• Cloudy or foul-smelling urine
• Upper urinary tract infection (pyelonephritis) additionally causes fever, chills, and flank pain

• Most commonly caused by Escherichia coli.
• Risk is increased by female anatomy, sexual activity, pregnancy, urinary catheter use, diabetes, and structural urinary tract abnormalities.

• Based on symptoms together with urinalysis showing leukocytes, nitrites, or blood.
• Urine culture and sensitivity testing where available, particularly for recurrent infection, pregnancy, or treatment failure.
• Further assessment or imaging for suspected pyelonephritis or complicated infection.

Uncomplicated lower UTI is treated with an oral antibiotic, with nitrofurantoin as a first-line option and amoxicillin-clavulanate as an alternative; a short course of about 3–7 days is usually sufficient.

Pregnant women with a UTI require prompt antibiotic treatment with an agent considered safe in pregnancy, since untreated infection increases the risk of preterm labour.

Pyelonephritis or complicated UTI requires hospital admission for intravenous antibiotics such as ceftriaxone, adjusted once culture results are available.

• Drink adequate fluids.
• Urinate after sexual intercourse.
• Maintain good perineal hygiene.
• Avoid delaying urination.
• Manage underlying risk factors such as diabetes promptly.