Urinary tract infection – a potentially deadly condition

Hello from Beth, one of your Pharmacy Chicks! Recently I have been reminded about the seriousness of a seemingly minor health condition. Eight years ago, my father died from sepsis related to an untreated urinary tract infection (UTI). As I write this article, my sister has been in the Critical Care Unit for 10 days being treated for sepsis related to an untreated UTI and is currently on a ventilator. It is possible that both of these situations could have been prevented if the signs and symptoms of the UTI had been recognized and treated.

The urinary system consists of the kidneys, ureters, bladder, and urethra. A urinary tract infection can happen in any part of the urinary system. Most infections occur in the lower urinary tract, the bladder and urethra. Women are more likely to develop a UTI than men. When the infection is in the bladder, also called cystitis, it may be painful and annoying. When it spreads to the kidneys more serious health problems can result.

A urinary tract infection may not always cause recognizable symptoms. When symptoms are felt, they can include the following:

• A strong urge to urinate that doesn’t go away
• A burning feeling when urinating
• Urinating often, and passing small amounts of urine
• Urine that looks cloudy
• Urine that looks red, bright pink, or brown which can be a sign of blood in urine
• Strong-smelling urine
• Pelvic pain in women – in the center of the pelvis and around the pubic bone

In older adults, symptoms of UTI may include hypotension (low blood pressure), tachycardia (fast heart rate), urinary incontinence, poor appetite, drowsiness, frequent falls, confusion, and delirium. It can often be mistaken for dementia.

There are more specific symptoms depending on what part of the urinary tract is involved. In the lower urinary tract (bladder and urethra), the symptoms may include burning when urinating, blood in urine, frequent urination, pelvic pressure, and lower belly discomfort. Once the kidneys are involved, the symptoms may include nausea, vomiting, back or side pain, a high fever, shaking, and chills. Minor UTIs will sometimes get better on their own with drinking plenty of fluids (mainly water) to flush your urinary tract system. Most UTIs, however, need antibiotic treatment.

         UTIs happen when bacteria enter the urinary tract through the urethra then spread to the bladder. Because of the female anatomy, the closeness of the urethra to both the anus and vagina place women at greater risk of developing UTIs. Escherichia coli (E. coli), a bacteria commonly found in the GI tract, is the primary cause of 80% of UTIs, especially in younger women. Staphylococcus saprophyticus accounts for 5-15% of UTIs, mostly in younger women. In older women, the remaining bacteria are Klebsiella, Proteus mirabilis, and Enterococci.

According to Mayo Clinic, the following are self-care measures that some providers recommend to prevent bladder infections:

• Drink plenty of liquids, especially water. Drinking water helps dilute the urine. That leads to urinating more often – allowing bacteria to be flushed from the urinary tract before an infection can begin.
• Urinate frequently. If you feel the urge to urinate, don’t delay urinating.
• Wipe from front to back after a bowel movement. This prevents bacteria in the anal region from spreading to the vagina and urethra.
• Take showers rather than tub baths. If you’re prone to infections, showering rather than taking a bath may help prevent them.
• Gently wash the skin around the genitals. Do this daily, but don’t use harsh soaps or wash too vigorously.
• Empty your bladder as soon as possible after sex. Drink a full glass of water to help flush bacteria.
• Avoid using deodorant sprays or hygiene products, such as douches and powders, in the genital area. These products can irritate the urethra and bladder.
• Cranberry juice or tablets containing proanthocyanidin are often recommended to help reduce the risk of recurrent bladder infections. Although research in this area is inconsistent, there is some evidence that cranberry may work to prevent recurrent infections for some people. Cranberry has not been shown to be an effective treatment if you already have a bladder infection. Avoid cranberry is you’re taking warfarin (Coumadin).

Antibiotics are the first treatment for urinary tract infections. The medicines commonly used for simple UTIs include Bactrim (sulfamethoxazole/trimethoprim), nitrofurantoin (Macrodantin or Macrobid), cephalexin, ceftriaxone, and Fosfomycin (Monurol). For a complicated UTI or kidney infection, a fluoroquinolone such as ciprofloxacin (Cipro) or levofloxacin (Levaquin) may be prescribed. A short course of 3 days of antibiotics is generally effective for a simple UTI. For more complicated or recurrent UTIs, a longer course of a week or more may be prescribed. In the case of a severe UTI, a hospital stay with IV antibiotics may be required.

It is important to be aware of the signs and symptoms of urinary tract infections, especially in those of us that are older. Seek treatment if common symptoms persist for more than three days or if fever, chills, nausea, or vomiting occur along with the more common symptoms. Remember, you can always stop by and see me at Sparta Drug Center or Jennifer at Payless Family Pharmacy with any questions you have about any of our topics or other healthcare needs. Pharmacy Chicks out!