Case Study on Urinary Tract Infections

What additional history would you obtain from this patient?

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Since the patient has been diagnosed with urinary tract infections, apart from the history that has been provided, additional history should be obtained from the patient so as to confirm the diagnosis and also come up with another differential diagnosis. The clinician should ask if there is any strong smell from the urine which is one of the definitive characteristics of urinary tract infection. One should also inquire if there is pelvic pain that is mostly seen in women who have urinary tract infection. The pain is mostly found in the center of the pelvis and may also radiate to the area around the region of the pubic bone (Foxman, 2013).

History of parasite infestation should also be taken into consideration since some parasitic infections such as Schistosoma hematobium can present with some of the symptoms that are similar to those seen in urinary tract infection. The patient should also be asked about her sexual activities, for instance, if she is sexually active, the number of sexual partners and if she uses protection. This is because sexually active women tend to have an increased risk of getting a urinary tract infection. The use of contraceptives should also be inquired since some certain birth contraceptives increase the risk of urinary tract infections such as spermicidal agents and use of diaphragms.

What are your treatment goals for this patient?

The main goals of treatment of this patient, who has a urinary tract infection include the eradication of the infection, reduce morbidity; prevent any complications from arising and reducing pain. The other important treatment goals include allowing proper passage of urine. To be able to attain these goals and improve the quality of life of the patient, both pharmacological and non-pharmacological treatment methods should be employed. The early treatment given to patients having urinary tract infection is recommended with the aim of reducing the disease from progressing to pyelonephritis (Roberts, 2011).

If you plan to start drug treatment today, what is your choice, dose, and duration of treatment?

If I plan to start treating the patient immediately, the drug of choice would be nitrofurantoin. Nitrofurantoin is one of the best antibiotics that is used in the treatment of urinary tract infection and it works by stopping the growth of bacteria. The drug is taken orally and dosage and duration will be based on the extent of the medical condition and the response of the patient to therapy. Since this patient has an acute urinary tract infection, the dose is 3mg/kg-day in four divided doses of the 100mg capsule for a duration of seven days (Hooton, 2012).

Provide patient education regarding your choice of treatment, as well as the non-pharmacologic aspect of treatment.

Patient education regarding nitrofurantoin which is the drug of choice for this patient is important as the patient is equipped with the adverse effects that she may experience and also given instruction on how to use the drug. The patient will be equipped with some of the side effects that she might experience such as allergic reactions, gastrointestinal disturbances, and drug interaction among others. The patients will also be given non-pharmacologic treatment that involves preventive measures such as abstinence, use of protection and being faithful to one partner (Foxman, 2010).

References

Foxman, B. (2010). The epidemiology of urinary tract infection. Nature Reviews Urology, 7(12), 653.

Foxman, B. (2013). Urinary tract infection. In Women and Health (Second Edition) (pp. 553-564).

Hooton, T. M. (2012). Uncomplicated urinary tract infection. New England Journal of Medicine, 366(11), 1028-1037.

Roberts, K. B. (2011). Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics, 128(3), 595-610.