From the Research
The most effective treatment for urinary tract infections (UTIs) is a 5-day course of nitrofurantoin, a 3-g single dose of fosfomycin tromethamine, or a 5-day course of pivmecillinam, as recommended by the most recent and highest quality study 1.
Overview of the Urinary System
The urinary system is a vital body system responsible for filtering blood and removing waste products through urine production. It consists of the kidneys, ureters, bladder, and urethra. The kidneys are bean-shaped organs located on either side of the spine that filter approximately 180 liters of blood daily, removing waste products, excess water, and electrolytes to form urine.
Key Components and Functions
- The kidneys contain tiny structures called nephrons, which contain glomeruli that filter blood and tubules that reabsorb necessary substances.
- The ureters are thin tubes that transport urine from the kidneys to the bladder, a muscular sac that stores urine until elimination.
- When the bladder fills to about 150-200 ml, stretch receptors signal the brain, creating the urge to urinate.
- During urination, the bladder muscle contracts while sphincters relax, allowing urine to flow through the urethra and exit the body.
Treatment of Urinary Tract Infections
- Nitrofurantoin, fosfomycin tromethamine, and pivmecillinam are the recommended first-line treatments for acute uncomplicated bacterial cystitis in otherwise healthy adult nonpregnant females 1.
- High rates of resistance for trimethoprim-sulfamethoxazole and ciprofloxacin preclude their use as empiric treatment of UTIs in several communities, particularly if patients who were recently exposed to them or in patients who are at risk of infections with extended-spectrum β-lactamases (ESBLs)-producing Enterobacteriales.
- Second-line options include oral cephalosporins such as cephalexin or cefixime, fluoroquinolones and β-lactams, such as amoxicillin-clavulanate.
Maintenance of Urinary System Health
- Proper hydration, limiting alcohol and caffeine intake, and practicing good hygiene help maintain urinary system health.
- The urinary system also plays crucial roles in maintaining blood pressure, electrolyte balance, and acid-base homeostasis.
- It is essential to use the new antimicrobials wisely for treatment of UTIs caused by MDR-organisms to avoid resistance development 1.