URINARY TRACT INFECTION IN THE FAMILY DOCTOR’S PRACTICE
Urinary tract infection (UTI) is one of the most common infectious diseases in groups of patients of all ages. In children, UTI may be the first sign of a congenital urinary tract abnormality. In adults and the elderly, this infection is associated with a high incidence of hospitalization. Asymptomatic bacteriuria is treated with antibiotics only in pregnant women due to possible side effects on the fetus. UTI is most commonly caused by Escherichia coli. In most cases, symptoms of cystitis are dysuria, lower abdominal discomfort, nocturia, hematuria; pyelonephritis – fever, chills, lower back pain, nausea and vomiting. In very young children, UTI should be suspected in the presence of persistent fever of unknown origin, and in elderly patients with sudden cognitive impairment. For suspected UTI it is necessary to take a urine test correctly, otherwise a false positive answer may be obtained. UTI is confirmed by urinalysis by dipstick with leukocyte esterase 1+, nitrites and blood, and/or by microscopic urine test for pyuria (>10 leukocytes in the field of vision) and significant bacteriuria (≥105 CFU/mL). When uncomplicated pyelonephritis is diagnosed, the first–line treatment for children is oral second–generation cephalosporins and for adults fluoroquinolones and cephalosporines.