From the Guidelines
Urinary tract infections (UTIs) and vomiting are connected through systemic inflammatory responses and nerve pathway interactions, with the most recent evidence suggesting that short-course antibiotics can be effective in treating UTIs, including pyelonephritis, with minimal risk of complications 1. The mechanism behind UTIs and vomiting involves the infection releasing endotoxins that enter the bloodstream, triggering systemic inflammatory responses that can stimulate the vomiting center in the brain. Additionally, severe kidney infections (pyelonephritis) can cause significant pain that triggers vagal nerve responses leading to nausea and vomiting. The body's immune response to infection also releases cytokines that can affect the chemoreceptor trigger zone in the brain, inducing vomiting. Some key points to consider in the management of UTIs and vomiting include:
- The use of short-course antibiotics, such as nitrofurantoin (100mg twice daily for 5-7 days), trimethoprim-sulfamethoxazole (160/800mg twice daily for 3 days), or ciprofloxacin (250mg twice daily for 3 days), to eliminate the bacterial infection 1.
- The importance of adequate hydration to help flush bacteria from the urinary tract and replace fluids lost through vomiting.
- The potential use of anti-emetics, such as ondansetron (4-8mg every 8 hours), to manage vomiting symptoms while the antibiotics address the underlying infection.
- The need for individualized treatment approaches, taking into account the severity of the infection, the presence of underlying medical conditions, and the risk of complications 1. Overall, the management of UTIs and vomiting requires a comprehensive approach that takes into account the underlying mechanisms of the infection, as well as the individual needs and circumstances of the patient.
From the Research
Mechanism behind UTI's
- Urinary tract infections (UTIs) are among the most common infections, with a broad bacterial spectrum and sometimes high antibiotic resistance rates 2.
- The clinical course of UTIs can range from spontaneous cure to fulminant sepsis 2.
- UTIs are one of the most common reasons people seek medical attention, with over 50% of women experiencing at least one UTI during their lifetime 3.
Vomiting associated with UTI's
- There is no direct evidence in the provided studies that links the mechanism of UTIs to vomiting.
- However, it is known that UTIs can cause symptoms such as nausea and vomiting, especially in severe cases 3.
Treatment of UTI's
- Adequate antibiotic therapy is based on the stratification into complicated and uncomplicated, as well as upper and lower infections, and on specific risk factors 2.
- The choice of empirical antibiotic therapy is made based on the classification of the UTI and the spectrum of pathogens 2.
- Ciprofloxacin is a commonly used antibiotic for the treatment of UTIs, with a well-known safety profile and excellent activity against most common uropathogens 3, 4, 5, 6.
- Network meta-analysis has shown that ciprofloxacin is one of the most effective treatments for UTIs, with a low rate of adverse effects 4, 5.