What are the symptoms of urinary tract infection
Urinary tract infection is caused by direct invasion of bacteria (few can be caused by fungi, protozoa, viruses). Urinary tract infection is divided into upper urinary tract infection and lower urinary tract infection. Upper urinary tract infection refers to pyelonephritis and lower urinary tract infection includes urethritis and cystitis. Pyelonephritis is divided into acute pyelonephritis and chronic pyelonephritis. It's good for women.
Symptoms of urinary tract infection
Acute pyelonephritis: 1. Sudden occurrence of disease 2 shivers, fear of cold 3. I'm hot. General malaise, headache, weakness. Loss of appetite, nausea, vomiting 6. Frequent urination, urgent urination, pain 7. Low back pain girl butt , kidney discomfort 8. Tenderness of upper ureter; 9. Tenderness of costal and lumbar points; 10. Percussion pain in renal region; 11. Tenderness in bladder region
Second, chronic pyelonephritis: 1. The performance of acute attack can be the same as acute pyelonephritis male masturbation toys , but usually much lighter vibrator for vaginal atrophy , even without fever, general discomfort, headache and other systemic manifestations, frequent urination, urgent urination, pain and other symptoms are not obvious. Edema 3. high blood pressure
Third, bladder, urethritis: frequent urination, urgent urination, pain in urination lockthecock , pain in the bladder area. Urethral discharge.
Treatment of urinary tract infection
one. Female uncomplicated acute urinary tract infection
(1) the treatment of acute cystitis is recommended for 3 days, that is, oral administration of compound sulfamethoxazole or ofloxacin or levofloxacin. As the curative effect of single-dose therapy is not as good as that of the three therapies, it is not recommended to use it at present. Areas where the resistance of pathogens to sulfamethoxazole reaches 10% to 20% can be treated with furan.
(2) the treatment of acute pyelonephritis is recommended to be treated with antibiotics for 14 days, and the treatment of mild acute pyelonephritis with highly effective antibiotics can be shortened to 7 days. For mild symptoms, oral quinolones can be used, if the pathogenic bacteria are sensitive to compound sulfamethoxazole, this drug can also be taken orally. If the pathogen is gram-positive, it can be treated with amoxicillin or amoxicillin / potassium clavulanate alone. For severe cases or those who cannot take oral drugs, they should be hospitalized, treated with quinolones or broad-spectrum cephalosporins intravenously, and aztreonam for patients with resistance to β-lactam antibiotics and quinolone antibiotics. If the pathogen is Gram-positive cocci, ampicillin / sulbactam sodium can be used and can be combined with drugs if necessary. If the condition improves, sensitive antibiotics can be selected for oral treatment with reference to the results of urine culture. It is very important to adjust and follow up the program during medication. Urine culture is carried out every 1-2 weeks to observe whether the urine bacteria turn negative. At the end of the course of treatment, quantitative culture of urine bacteria was carried out at the 2nd and 6th week after drug withdrawal, and it was best to reexamine once a month in the future.
(3) due to various basic diseases, complex acute pyelonephritis is prone to serious complications such as renal cortical medulla abscess, perirenal abscess, renal nipple necrosis and so on. This kind of patient needs hospitalization. First of all, it is necessary to timely and effectively control basic diseases such as diabetes and urinary tract infarction, and cooperate with urologists and other related doctors when necessary. Otherwise, it is difficult to cure the disease with antibiotics alone. Secondly, according to experience, intravenous treatment with broad-spectrum antibiotics. During the period of medication, the treatment regimen should be adjusted in time according to the changes of the disease and / or the results of bacterial drug sensitivity test, and some patients still need to be combined with drugs for at least 10-14 days.
two. Male cystitis
All male patients with cystitis should remove prostatitis. Uncomplicated acute cystitis can be treated with compound sulfamethoxazole and quinolones at the same dose as female patients, but patients with complex acute cystitis can be treated with ciprofloxacin or levofloxacin for 7 days for 14 days.
three. Urinary tract infection during pregnancy
(1) asymptomatic bacterial urine sensation. The incidence of asymptomatic bacteriuria during pregnancy is as high as 2%-7%. It often occurs in the first month of pregnancy, of which 40% of cases can develop acute pyelonephritis during pregnancy. Therefore, it is recommended that pregnant women are usually examined for urine culture in the early stage of pregnancy. At present, anti-infective treatment is recommended for such patients. One of the following options can be chosen: ① nitrofurantoin ② cefpodoxime ③ amoxicillin / potassium clavulanate. Patients are asked to stop taking drugs for a week and then go to the hospital to review their urine care, and then recheck once a month until the end of pregnancy. For people with recurrent asymptomatic bacteriuria, antibiotic prophylaxis can be taken during pregnancy and take furan or cefbroxol before going to bed every night.
(2) Acute cystitis can be treated with one of the following regimens: ① furan, ② cefpod loss ③ amoxicillin / potassium clavulanate. Then the treatment plan was adjusted according to the results of urinary bacterial culture. The course of treatment is generally recommended for 7 days.
(3) Acute pyelonephritis must be mainly treated with antibiotics intravenously. 48 hours after normal or after the clinical symptoms are obviously improved, it can be treated with oral antibiotics. First of all, the empirical treatment was used, ceftriaxone was used, and the treatment scheme was adjusted according to the results of urinary bacterial culture. the total course of treatment was 10-14 days.
four. Asymptomatic bacterial urinary tract infection
There is no need to treat premenopausal women, non-pregnant patients, patients with diabetes, the elderly, spinal cord injury and asymptomatic bacteriuria patients with indwelling catheters. However, for patients who undergo prostatic surgery or other urinary operations that may lead to urinary mucosal bleeding or check asymptomatic bacteriuria, sensitive antibiotics should be treated according to the results of bacterial culture.
five. Urinary tract infection associated with urinary catheter
Female patients with urethra-related asymptomatic bacterial urine without antibiotics 48 hours after catheter removal should be treated with sensitive antibiotics for 14 days according to the results of urine culture.
Symptoms of urinary tract infection
Acute pyelonephritis: 1. Sudden occurrence of disease 2 shivers, fear of cold 3. I'm hot. General malaise, headache, weakness. Loss of appetite, nausea, vomiting 6. Frequent urination, urgent urination, pain 7. Low back pain girl butt , kidney discomfort 8. Tenderness of upper ureter; 9. Tenderness of costal and lumbar points; 10. Percussion pain in renal region; 11. Tenderness in bladder region
Second, chronic pyelonephritis: 1. The performance of acute attack can be the same as acute pyelonephritis male masturbation toys , but usually much lighter vibrator for vaginal atrophy , even without fever, general discomfort, headache and other systemic manifestations, frequent urination, urgent urination, pain and other symptoms are not obvious. Edema 3. high blood pressure
Third, bladder, urethritis: frequent urination, urgent urination, pain in urination lockthecock , pain in the bladder area. Urethral discharge.
Treatment of urinary tract infection
one. Female uncomplicated acute urinary tract infection
(1) the treatment of acute cystitis is recommended for 3 days, that is, oral administration of compound sulfamethoxazole or ofloxacin or levofloxacin. As the curative effect of single-dose therapy is not as good as that of the three therapies, it is not recommended to use it at present. Areas where the resistance of pathogens to sulfamethoxazole reaches 10% to 20% can be treated with furan.
(2) the treatment of acute pyelonephritis is recommended to be treated with antibiotics for 14 days, and the treatment of mild acute pyelonephritis with highly effective antibiotics can be shortened to 7 days. For mild symptoms, oral quinolones can be used, if the pathogenic bacteria are sensitive to compound sulfamethoxazole, this drug can also be taken orally. If the pathogen is gram-positive, it can be treated with amoxicillin or amoxicillin / potassium clavulanate alone. For severe cases or those who cannot take oral drugs, they should be hospitalized, treated with quinolones or broad-spectrum cephalosporins intravenously, and aztreonam for patients with resistance to β-lactam antibiotics and quinolone antibiotics. If the pathogen is Gram-positive cocci, ampicillin / sulbactam sodium can be used and can be combined with drugs if necessary. If the condition improves, sensitive antibiotics can be selected for oral treatment with reference to the results of urine culture. It is very important to adjust and follow up the program during medication. Urine culture is carried out every 1-2 weeks to observe whether the urine bacteria turn negative. At the end of the course of treatment, quantitative culture of urine bacteria was carried out at the 2nd and 6th week after drug withdrawal, and it was best to reexamine once a month in the future.
(3) due to various basic diseases, complex acute pyelonephritis is prone to serious complications such as renal cortical medulla abscess, perirenal abscess, renal nipple necrosis and so on. This kind of patient needs hospitalization. First of all, it is necessary to timely and effectively control basic diseases such as diabetes and urinary tract infarction, and cooperate with urologists and other related doctors when necessary. Otherwise, it is difficult to cure the disease with antibiotics alone. Secondly, according to experience, intravenous treatment with broad-spectrum antibiotics. During the period of medication, the treatment regimen should be adjusted in time according to the changes of the disease and / or the results of bacterial drug sensitivity test, and some patients still need to be combined with drugs for at least 10-14 days.
two. Male cystitis
All male patients with cystitis should remove prostatitis. Uncomplicated acute cystitis can be treated with compound sulfamethoxazole and quinolones at the same dose as female patients, but patients with complex acute cystitis can be treated with ciprofloxacin or levofloxacin for 7 days for 14 days.
three. Urinary tract infection during pregnancy
(1) asymptomatic bacterial urine sensation. The incidence of asymptomatic bacteriuria during pregnancy is as high as 2%-7%. It often occurs in the first month of pregnancy, of which 40% of cases can develop acute pyelonephritis during pregnancy. Therefore, it is recommended that pregnant women are usually examined for urine culture in the early stage of pregnancy. At present, anti-infective treatment is recommended for such patients. One of the following options can be chosen: ① nitrofurantoin ② cefpodoxime ③ amoxicillin / potassium clavulanate. Patients are asked to stop taking drugs for a week and then go to the hospital to review their urine care, and then recheck once a month until the end of pregnancy. For people with recurrent asymptomatic bacteriuria, antibiotic prophylaxis can be taken during pregnancy and take furan or cefbroxol before going to bed every night.
(2) Acute cystitis can be treated with one of the following regimens: ① furan, ② cefpod loss ③ amoxicillin / potassium clavulanate. Then the treatment plan was adjusted according to the results of urinary bacterial culture. The course of treatment is generally recommended for 7 days.
(3) Acute pyelonephritis must be mainly treated with antibiotics intravenously. 48 hours after normal or after the clinical symptoms are obviously improved, it can be treated with oral antibiotics. First of all, the empirical treatment was used, ceftriaxone was used, and the treatment scheme was adjusted according to the results of urinary bacterial culture. the total course of treatment was 10-14 days.
four. Asymptomatic bacterial urinary tract infection
There is no need to treat premenopausal women, non-pregnant patients, patients with diabetes, the elderly, spinal cord injury and asymptomatic bacteriuria patients with indwelling catheters. However, for patients who undergo prostatic surgery or other urinary operations that may lead to urinary mucosal bleeding or check asymptomatic bacteriuria, sensitive antibiotics should be treated according to the results of bacterial culture.
five. Urinary tract infection associated with urinary catheter
Female patients with urethra-related asymptomatic bacterial urine without antibiotics 48 hours after catheter removal should be treated with sensitive antibiotics for 14 days according to the results of urine culture.
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