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Although catheter use should be minimized in all patients, particularly those at higher risk of CAUTI and mortality (e.g. the elderly or those with impaired immunity), [2] a meta analysis suggests there is insufficient evidence to determine the value of different policies for replacing long term urinary catheters on patient outcomes.
A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. [1] Lower urinary tract infections may involve the bladder ( cystitis ) or urethra ( urethritis ) while upper urinary tract infections affect the kidney ( pyelonephritis ). [ 10 ]
Urinary tract infection in pediatric patients is a significant clinical issue, affecting approximately 7% of fevered infants and children. [43] If left untreated, the infection can ascend from the bladder to the kidneys, resulting in acute pyelonephritis, which leads to hypertension , kidney scarring , and end-stage kidney disease .
Urinary bladder disease includes urinary bladder inflammation such as cystitis, bladder rupture and bladder obstruction (tamponade).Cystitis is common, sometimes referred to as urinary tract infection (UTI) caused by bacteria, bladder rupture occurs when the bladder is overfilled and not emptied while bladder tamponade is a result of blood clot formation near the bladder outlet.
[1] [2] [3] In clinical studies, it has been found to reduce total number of UTIs by about 70%, to increase UTI-free rates from around 25% to 57%, and to increase time to next UTI from about 1.6 months to 9.0 months. [2] [4] [5] [6] It has also been found to reduce subjective UTI symptoms, reduce antibiotic use, and improve quality of life.
Other patients may develop a shock-like condition and may require admission to a hospital. Serious complications of untreated urinary retention include bladder damage and chronic kidney failure. [4] Urinary retention is a disorder treated in a hospital, and the quicker one seeks treatment, the fewer the complications. [citation needed]
Medullary sponge kidney is a congenital disorder of the kidneys characterized by cystic dilatation of the collecting tubules in one or both kidneys.Individuals with medullary sponge kidney are at increased risk for kidney stones and urinary tract infection (UTI).
Nitrofurantoin is contraindicated in patients with decreased renal function (CrCl < 60 ml/min) due to systemic accumulation and subtherapeutic levels reached in the urinary tract. [9] However, a retrospective chart review suggests the data for this cutoff are slim and a cutoff of CrCl < 40 ml/min would be more appropriate. [ 42 ]