A urinary tract infection occurs when bacteria enter the urinary tract, infecting parts like the urethra, bladder, and sometimes kidneys. Common symptoms include burning during urination and frequent urination. Escherichia coli is the most common cause. Treatment involves antibiotics like trimethoprim/sulfamethoxazole. Preventive measures include drinking cranberry juice and good hygiene after sex.

1. Urinary Tract Infection
(UTI)
Presented by Miss Sudipta Roy
Designation : Associate Professor
East Point College of Pharmacy , Bangalore

2. • A urinary tract infection is an infection of the
urinary tract, which is anywhere from the kidneys
to ureters , urinary bladder and urethra .UTI is
defined as significant bacteriuria in the presence of
symptoms . UTIs are common infections that
happen when bacteria , often from the skin or
rectum , enter the urethra , and infect the urinary
tract. The infections can affect several parts of the
urinary tract, but the most common type is a
bladder infection (cystitis).
• kidney Infection (pyelonephritis) is often another
type of UTI. They are less common , but more

3. Clinical Manifestations.
• Symptoms of a UTI depend on what part of the Urinary tract is infected.
• Lower tract UTI symptoms.
• Lower tract UTIs affect the urethra and bladder.Symptoms of a lower tract UTI
include :
• Burning with urination
• Increased frequency of urination without passing much urine.
• Increased Urgency of Urination
• Bloody Urine
• Cloudy Urine
• Urine that looks like cola or tea
• Urine that has a strong odor
• Pelvic pain in women
• Rectal pain in men
• Upper tract UTI symptoms
• Upper tract UTIs affects the kidneys. These can be potentially life threatening if
bacteria move from the infecte kidney into the blood. This condition , called
urosepsis , can cause dangerously low blood pressure, shock and death. Symptoms of
an upper tract UTI include -

4. • pain and tenderness in the upper back and sides
• chills
• fever
• nausea
• vomiting

5. Classification of UTI.
• Upper UTI :
• Acute pyelonephritis
• Chronic pyelonephritis
• Interstitial pyelonephritis
• Renal abscess
• Peripheral abscess
• Lower UTI :
• Cystitis
• Prostatitis
• Urethritis

6. • Both upper and lower UTI are further divided into complicated and
uncomplicated.
• Etiology of UTI :
• Common organisms that cause UTIs include :
• Escherichia coli- It is reponsible to infections in young sexually active women.
• Less common organisms include :
• Escherichia coli - It is responsible for about 80 of the UTIs.
• Staphylococcus saprophyticus : It is restricted to infections in young sexually
active women. Less common organisms include -
• Proteus mirabilis - It is a gram-negative enteric bacterium .
• Klebsiella , Pneumoniae, Enterococcus species.
• The risk factors are -
• Aging
• Diabetes Mellitus
• Impaired immune system

7. • In males
• Prostatic hypertrophy
• Bacterial prostatis
• Age
• In females
• Shorter urethra
• Sexual Intercourse
• Contraceptives
• Incomplete bladder emptying with age

8. Pathophysiology of UTI
• The urinary tract is normally sterile. UTI which is
uncomplicated involves urinary bladder in a host
without underlying renal or neurologic disease.
• The clinical cause is cystitis , that invades bladder
mucosal by enteric coli from bacteria. E.g.
Escherichia coli that inhibit the periurethral vaginal
introitus and ascend into bladder via the urethra.
• Sexual intercourse may promote this migration, and
cystitis is common in healthy young women. Urine
is a good culture medium favorable for baterial
growth. If the pH is 5.5 or less than with high
protein . Organic acids enhances acidification of the

9. • Normally , a thin film of urine remains in the
bladder after emptying and if any bacteria remain
in it are removed by the mucosal cell productionof
organic acids. If the mechanism of the lower
urinary urinary tract with involvement of upper
tract or kidney will result in pyelonephritis .

10. • Prevention.
• The following measures are taken , especially in women with
recurrent infections to overcome the UTI are :
• Cleaning the urinal meatus after intercourse with an atiseptic .
• Cranberry juice decreases the incidence of UTI which is due to
tannins found only in cranberries and blueberries. It prevents
the adherence of certain pathogens i.e. E.coli to the
epithelium of the urinary bladder.
• For post menopaus women at random controlled trial has
shown that intravaginal application of topical estrogen cream
can prevent recurrent cystitis.
• Often long courses of low dose antibiotics are taken at night to
prevent unexplained cases of reoccurring cystitis.

11. • Pharmacological Treatment.
• Antibiotics usually are the first line treatment for
urinary tract infections. Type of drugs are
prescribed and for how long depend on the health
condition and the type of bacteria in your urine.
Drugs commonly recoomended for simple UTIs
include :
• Trimethoprim/sulfamethoxazole
• Fosfomycin
• Nitrofurantoin
• Cephalexin

12. • The group of antibiotic medicines known as
fluroquinolone -such as ciprofloxacin (Cipro),
Levofloxacin and others-is not commonly
recommended for simple UTIs, as the risks of these
medicines generally outweigh the benefits for
treating uncomplicated UTIs. In some cases, such as
complicated UTI or kidney infection. Doctor might
prescribe a fluroquinolone medicine if there are no
other treatment options.

13. • Often , UTI symptoms clear up within a few days of
starting treatment. But the patient may need to
continue antibiotics for a week or more. Entire
course of antibiotics as prescribed.
• For an uncomplicated UTI that occurs when the
patient is otherwise healthy, the doctor may
recommend a shorter course of treatment , such as
taking an atibiotic for one to three days. But
whether this short course of treatment is enough
to treat the infection depends on your particular
symptoms and medical history.

14. • The doctor may also prescribe a pain medication
(analgesic) that numbs the bladder and urethra to
releive burning while urinating, but pain usually is
releived soon after starting an antibiotic.