Urinary Tract Infection (UTI)

Infections that affect the urinary tract- kidneys, ureters, bladder and urethra are commonly known as UTI. In women, infections begin by introduction of bacteria to the vaginal area, followed by ascension through the urethra, into the bladder, and possibly, into the kidneys. When there is no concern of infection beyond the bladder, it is considered a simple Cystitis/UTI. When infection is suspected to have extended beyond bladder with features such as flank pain/ CVA tenderness, and fever, chills rigors, significant fatigue, and malaise we consider this complicated UTI.

Lower UTI (simple UTI or cystitis involving the bladder and urethra.

Simple cystitis causes mild to moderate symptoms. Symptoms usually improve within 24 hours. The infection has not spread to the kidneys and is not causing severe systemic symptoms. 

 Symptoms may include:

• Burning and soreness when urinating (dysuria)
• Urinary frequency and urinary urgency
• Incontinence 
• Bladder discomfort / suprapubic pain
• Urine color may be brown, murky and with a strong smell
• Feeling unwell and mild fever

Upper UTI (complicated UTI) - involve kidneys (pyelonephritis) and ureters.

Severe symptoms arise when infection moves up from the bladder to the kidneys or when infection affects the whole body. Infection of the kidneys is known as pyelonephritis and requires urgent medical attention and may sometimes require hospital treatment.

Any of the following symptoms may indicate serious pyelonephritis or other serious infection:

• Back pain (indication of possible infection in the kidney)
• Fever> 99.9F/37.7C (high temperature, flushing, shivering, feeling hot and cold)
• Chills, rigors, flank pain, CVA tenderness
• Nausea and sickness and loss of appetite
• Generalized aching and flu-like feeling and confusion

All the above symptoms suggest something more serious than a simple UTI and the need to seek medical advice immediately.

Recommended treatment for simple UTI

• Nitrofurantoin (Macrobid)
• Trimethoprim-sulfamethoxazole (Bactrim)

Alternative options (due allergies or intolerance to recommended treatment)

• Fluoroquinolone (Ciprofloxacin or Levaquin)
• Augmentin
• Ciprofloxacin’
• Cephalosporin (cefpodoxime, cefdinir, and cefadroxil

Recommended treatment Complicated UTI -Extended day treatment with

• Fluoroquinolone (Ciprofloxacin or Levaquin)
• Trimethoprim-sulfamethoxazole (Bactrim)
• Amoxicillin-clavulanate (Augmentin)
• Cephalosporin (cefpodoxime, cefdinir, and cefadroxil)

Following the completion of your consultation, please be advised that your prescription will be available at the pharmacy in approximately 40 minutes.