Kass EH.
(UTI = urinary tract infection)Diagnostic approach to urinary tract infections in adults. Newman D,
Consequently, clinicians consider hyperthyroidism a risk factor for development of subclinical bacteriuria, and many recommend urine culture when evaluating hyperthyroid cats.To compare the prevalence of subclinical bacteriuria (based on positive urine culture) in untreated hyperthyroid cats to that in euthyroid cats of similar age and sex.Three hundred and ninety‐three hyperthyroid cats presented for radioiodine treatment and 131 euthyroid cats (≥7 years of age) presented for routine examination. Nicolle LE. Within 6 months of radioiodine treatment, an additional 43 cats (10.9%) developed azotemia (serum creatinine concentration range, 2.2‐3.8 mg/dL) as their hyperthyroidism resolved. Urinary interleukin-8 with asymptomatic bacteriuria in pregnancy. In human patients, standard of care is not to treat asymptomatic bacteriuria with antimicrobials, unless the patient is pregnant, or having invasive urinary procedures performed.Direct comparisons between human and veterinary medicine can be problematic, and future prospective studies comparing outcomes with and without antimicrobial treatment in cats with subclinical bacteriuria are needed.
Krieger JN,
Rho JP. Alternatively, it is possible that methimazole has a direct protective effect against development of subclinical bacteriuria.
Subclinical bacteriuria is defined as a positive bacterial urine culture in the absence of clinical evidence of urinary tract infection (UTI).
These factors include conditions often encountered in elderly men, such as enlargement of the prostate gland, blockages and other problems necessitating the placement of indwelling urinary devices, and the presence of bacteria that are resistant to multiple antibiotics. Abrutyn E. Fortunately, most recurrent UTIs in young women are uncomplicated infections caused by different organisms. Instead, these patients should undergo an abbreviated laboratory work-up in which the presence of pyuria is confirmed by traditional urinalysis (wet mount examination of spun urine), the cell-counting chamber technique or a dipstick test for leukocyte esterase.A positive leukocyte esterase test has a reported sensitivity of 75 to 90 percent in detecting pyuria associated with a UTI. A seven-day course should be considered in pregnant women, diabetic women and women who have had symptoms for more than than one week and thus are at higher risk for pyelonephritis because of the delay in treatment.Up to 20 percent of young women with acute cystitis develop recurrent UTIs.
In all of the methimazole‐treated cats, the drug was discontinued ≥1 week (median, 7 days; IQR, 7‐15 days; range, 7‐150 days) before evaluation. N Engl J Med 1993;329:1328–34Adapted with permission from Fihn SD, McGee SR. Outpatient medicine. Holmes KK. In: Mobley HL, Warren JW, eds. Philadelphia, Pa.: Saunders, 1992*—Estimated cost to the pharmacist based on average wholesale prices, rounded to the nearest half dollar, in Red book. Stamm WE. A reassessment of the importance of “low-count” bacteriuria in young women with acute urinary symptoms. Stamm WE, Millar LK, This article clarifies these issues by reviewing the approach to the diagnosis and treatment of each patient group at risk for UTIs. Of the signalment factors evaluated, only female sex was a significant risk factor (odds ratio [OR], 6.9; Hyperthyroid cats are not at risk for subclinical bacteriuria.
Short-term treatment of uncomplicated lower urinary tract infections in women.
Tiu F, Thus, three-day regimens appear to offer the optimal combination of convenience, low cost and an efficacy comparable to that of seven-day or longer regimens but with fewer side effects.Quinolones that are useful in treating complicated and uncomplicated cystitis include ciprofloxacin, norfloxacin, ofloxacin, enoxacin (Penetrex), lomefloxacin (Maxaquin), sparfloxacin (Zagam) and levofloxacin (Levaquin).On the basis of cost and efficacy, trimethoprim-sulfamethoxazole remains the antibiotic of choice in the treatment of uncomplicated UTIs in young women.
Vincent LM, Role of host defenses. Running KR, The initial empiric therapy for these patients should include an agent with a broad spectrum of activity against the expected uropathogens.
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