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Urinary Tract Infection
Mr. Shaikh Akhil. M.
Asst. Prof. Dept. of Pharmacology,
BCCO Pharmacy, Naigaon,
Urinary Tract Infection - Introduction
UTI is a common disorder at all age & gender
Types- A. Lower urinary tract infection B. upper UTI
A. Lower UTI- 1. increase frequency of urination without passing much
urine 2. burning with urination 3. cloudy urine 4. urine look like- cola
or tea 5. strong odour 6. pain
B. Upper UTI- 1. pain tenderness in upper back side 2. chills with
headache 3. fever-come-go 4. nausea – vomiting
Cause + Risk factor- 1. female anatomy 2. certain birth control 3.
menopause 4. infection of bladder , urethra 5. blockage of UT 6.
suppressed immune system 7. catheter use + stent use in stone
It is important to know the cause and type of microorganism
95% case of uncomplicated UTI in female – due to gram negative
bacilli. E.coli is common-80%, other like- staphylococci .
Aerobactex, pseudomonas aerogenosa, entercocci, streptococci,
Goal for treatment –
1. To eradicate the infecting organism
2. To provide symptomatic relief by altering PH of urine or giving –
3. To prevent and treat recurrence of UTI
4. To identify and treat predisposing factors
General principle of therapy-
1. In acute case- appropriate drugs may be started as soon as urine
sample has collected for bacteriological examination
2. In chronic case- mixed infection and renal failure may possible – no
desperate hurry to start therapy before the case is throughly
3. Pregnant woman must be screen fore bactreiurea in 1st trimester
4. Alkalisation of urine – decrease irritation of urinary tract
Drug therapy-Classification of drug –
Bacteriostatic – sulphonamide, doxycycline, nitrofurantoin
Bacterocidal- cotrimoxazole, ampicillin, extended spectrum penicillin,
aminoglycoside, fluroquinolones, azithromycin
Urinary antiseptic- orally administerd antimicrobial agent which attain
antibacterial concentration only in urine with no systemic antibacterial effect
They are concentrated in kidney tubules and useful in lower urinary tract
infection. Urinary antiseptic- at locally
Nitrofurantoin – low conc.- static higher conc.- cidal.
Activity is increase in acidic urine 2. many gram negative bacteria except
proteus E.coli now uses E.coli
Mechanism – susceptible bacteria enzymatically reduce nitrofurantoin to
generate reactive intermediate which affect DNA & affect protein synthesis
Containdication- renal failure, pregnancy & neonates
ADR- GI intolarance, nausea, vomiting, epigastric pain, diarrhoea
Use- uncomplicated lower UTI now reserved drug – 50-100 mg TDS- 5-