Acute cystitis is an infection of the bladder most commonly due to the coliform bacteria (especially Escherichia coli) and occasionally gram-positive bacteria (enterococci) . The route of infection is typically ascending from the urethra. Viral cystitis due to adenovirus is sometimes seen in children but is rare in adults.
Essentials of Diagnosis:
Irritative voiding symptoms.
Patient usually a febrile.
Positive urine culture; blood cultures may a l so be positive.
Women who have more than three episodes of cystitis per year are considered candidates for prophylactic antibiotic therapy to prevent recurrence after treatment of urinary tract infection. Prior to institution of therapy, a thorough urologic evaluation is warranted to exclude any anatomic abnormality ( eg, stones, reflux, fistula) . The three most commonly used oral agents for prophylaxis are trimethoprimsulfamethoxazole (40 mg/200 mg), nitrofurantoin ( 1 00 mg), and cephalexin (250 mg) . Single dosing at bedtime or at the time of intercourse is the recommended schedule.
The risk of acquiring a catheter-associated urinary tract infection in hospitalized patients can be minimized by using indwelling catheters only when necessary, implementing systems to ensure removal of catheters when no longer needed, using antimicrobial catheters in high-risk patients, using external collection devices in select men, identifying significant postvoid residuals by ultrasound, maintaining proper insertion techniques, and utilizing alternatives such as intermittent catheterization.
Sources: 2017 CURRENT Medical Diagnosis & Treatment FIFTY-SIXTH EDITION.
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