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Chemical structure of nitrofurantoin. Nitrofurantoin is regarded as the first-line agent for simple cystitis, with an efficacy rate ranging from 88% to 92%. [9] It can also be a prophylactic agent to prevent long-term UTIs. [10] This antibacterial medication is effective against both gram-positive and gram-negative bacteria. [11]
Nitrofurantoin is pregnancy category A in Australia. [3] It is one of the few drugs commonly used in pregnancy to treat UTIs. [38] There is a potential risk of hemolytic anemia in the newborn when used near time of delivery. [3] Newborns of women given this drug late in pregnancy had a higher risk of developing neonatal jaundice. [39]
It has been easy to test for the presence of gonorrhea by viewing a Gram stain of the urethral discharge under a microscope: The causative organism is distinctive in appearance; however, this works only with men because other non-pathogenic gram-negative microbes are present as normal flora of the vagina in women. Thus, one of the major causes ...
In women, urethritis can be diagnosed with a number of tests including: urine test, blood test, vaginal culture, cytoscopy, or a nucleic acid test. [18] Women will also have abdominal and pelvic exams to check for urethral discharge, and tenderness of the lower abdomen or urethra.
Rates of asymptomatic bacteria in the urine among men over 75 are between 7–10%. [11] 2–10% of pregnant women have asymptomatic bacteria in the urine and higher rates are reported in women who live in some underdeveloped countries. [108] Urinary tract infections may affect 10% of people during childhood. [7]
Urethral syndrome is defined as symptoms suggestive of a lower urinary tract infection but in the absence of significant bacteriuria with a conventional pathogen. [1] It is a diagnosis of exclusion in patients with dysuria and frequency without demonstrable infection. [2] In women, vaginitis should also be ruled out. [3]
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