内科学教学课件：Urinary Tract Infection.pptVIP

2.urethral syndrome: exhibit irritative voiding symptom no significant bacteriuria Infective urethral syndrome: caused by other pathogens such as virus, mycoplasms, chlamydia. Urinalysis show pyuria. Non- Infective urethral syndrome: no WBC is seen with urinalysis. Probably it is because of psychological problems. treatment Antibiotics G—Bacillus （ sulfonamide, quinolones, β-lactam drug semisythetic penicillins , cephalosporins ） After the drug sensitivity test for offending organisms is available, then antibiotics are given according to the test. Acute cystitis: single dose therapy and a 3-day course of therapy ↓ followed up to see whether the infection is controlled or not it should not be used in patients with pregnancy, complicated infection, suspected pyelonephritis or male patients Acute pyelonephritis intensive antimicrobial therapy should be administrated. antibiotics for 14 days orally. no effect within 72h→ adjust the treatment . Moderate acute pyelonephritis : intravenous therapy of antibiotics ↓defervesces for 72h oral agent at least 14 days Acute pyelonephritis Severe acute pyelonephritis : a combination of antibiotics are given intravenously, often an aminoglycoside combined with a β-lactam drug or cephalosporins. Therapy for recurrent UTI ： Relapsing infection： infection occur within 6w of the cessation of antimicrobial therapy and is caused by the same organism. Reinfection： caused by an organism which is different from the original one. Therapy for recurrent UTI ： receive short course therapy of 7 days→ followed up 7 days after cessation of therapy. If no symptom，bacteriuria and pyuria → cure reinfection； Still with symptoms, bacteriuria and pyuria → treat according to drug sensitivity test. If succeeded Reinfection, if failed → a big dose ant