Urinary Tract Infection - Highlights

Highlights

Antibiotic Treatment for Urinary Tract Infections (UTIs)

Quinolone antibiotics such as ciprofloxacin (Cipro) have overtaken trimethoprim-sulfamethoxazole (TMP-SMX) as a first-line treatment for UTIs, according to a 2006 study in the Archives of Internal Medicine. Doctors are prescribing more quinolones due to increasing antibiotic resistance to sulfa antibiotics such as TMP-SMX. Experts are now concerned that bacteria will develop resistance to quinolones.

Children and UTIs

• Children who have received antibiotics to prevent UTIs frequently develop infections resistant to cephalosporin antibiotics, suggests a 2006 study in Archives of Pediatrics and Adolescent Medicine. Experts recommend an aminoglycoside antibiotic such as gentamicin (Garamycin) as an alternative drug.
• Children with UTIs can develop vesicoureteral reflux (VUR), a condition where urine backs up from the bladder into the kidneys. Although long-term antibiotics are sometimes prescribed for VUR to help prevent kidney infection, a 2006 study reported that antibiotic treatment is not helpful and that mild-to-moderate VUR will not increase the risk of kidney infection or scarring. Many experts recommend surgery over antibiotics for treatment of severe VUR.

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Interstitial Cystitis

• Some foods and beverages may worsen interstitial cystitis (IC) symptoms, suggests research presented at the 2006 American Urological Association (AUA) scientific meeting. Experts recommend that patients with IC avoid coffee, alcohol, cola, vinegar, citrus fruits, tomatoes, chili, strawberries, pineapple, onions, pizza, chocolate, and apples.
• Other disease conditions frequently accompany interstitial cystitis, according to a 2006 study in the Journal of Urology. Women with IC may also have allergies, sinusitis, urinary incontinence, and irritable bowel syndrome. Women who have pelvic pain and depression may experience more severe IC symptoms.
• Hyperbaric oxygen therapy may help relieve IC symptoms, according to preliminary research presented at the AUA meeting.

Review Date: 06/16/2006
Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital