A 28 year presents to your office with symptoms of a urinary tract infetion. This is her second infection in two months. You treated the last infection with Bactrim DS for 3 days. Her symptoms never really improved. Now she has worsening lower abdominal discomfort, dysuria & frequency. She has ha no fever or flank pain. Physical examination shows only mild suprapubic tenderness.
Approximately 15-20% of women develop recurrent UTI at some stage during their life. Cystitis is diagnosed when a clean-catch urine sample has a concentration of at least 1,00,000 bacteria /ml of urine & when the patient suffers the symptoms of dysuria, frequency , urgency & pain. The most common etiology of UTI is e-coli. Treatment of a UTI involves obtaining a culture & staring a patient on an antibiotic regimen of sulfa or nitrofurantoin, which have good coverage against e-coli & are relatively inexpensive.
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