It is now accepted practice to have pharmacists and nurses manage disease states by following accepted and approved clinical guidelines. Until January 1994, the Mayo Clinic used 7- to 10-day anti-biotic regimens for acute female cystitis. The medical director for practice guidelines, Dr. Angstman and his committee, redesigned the antibiotic order sheet to include check-off boxes, allowing the physicians to make ordering the smaller supply the easiest option. This promoted the goal of increasing the number of three-day regimens prescribed for TMP-SMX [Septra, Bactrim], nitrofurantoin, or ciprofloxacin. The results were that “the shorter regimen has proven efficacious in treating cystitis, with fewer antibiotic-related …
[ Continue Reading... ]Category: Urological Diseases
The goals of treatment are to eradicate the bacteria, relieve symptoms, avert irreversible damage, and prevent recurrence. Antibiotics serve this purpose by quickly eliminating the organism(s) and shortening the length of symptom discomfort. Since the choice of antibiotic treatment is empiric, based on predictable eradication for a defined group of bacteria, other factors become appropriate to consider. TABLE 5 lists additional considerations for antibiotic selection. TABLE 5: Factors to Consider When Selecting an Antibiotic Patient drug allergies Potential drug and food interactions Previous infection history or recent antibiotic exposure Patient compliance Potential for adverse effects—rash, gastrointestinal upset, vaginal candidiasis Local microbial sensitivity or resistance patterns Route of delivery Dosing schedule Duration …
[ Continue Reading... ]Assessment A preliminary diagnosis of acute female cystitis (AFC) is made by assessing patient risk factors, signs and symptoms. A combination of the classic words, “I have this pain when I urinate (dysuria), urgency, burning or frequency that just started,” describes the symptoms of acute cystitis. The urgent need to urinate may allow only a few drops of urine to pass before the burning sensation occurs and the need to urinate begins again. The urine may be cloudy, bloody, or foul-smelling. Infrequently there may be a mild fever or pain in the lower back or groin area. Dysuria Dysuria is associated with bacterial cystitis, STDs (sexually transmitted diseases), …
[ Continue Reading... ]Acute bacterial cystitis affects 8–10 million Americans a year, according to the American Foundation for Urological Diseases — and most of these patients are women. The National Institute of Diabetes and Digestive and Kidney Diseases notes that acute cystitis prompts about 9.6 million doctor visits annually; $4.5 billion is spent on 11 million antibiotic prescriptions. Occurring in otherwise healthy young women with no congenital, neurological or structural abnormalities, acute, symptomatic, uncomplicated urinary tract infection (UTI) or acute female cystitis (AFC) is the most common infection next to the common cold. Twenty-five to 40% of females will experience an acute UTI in their lives, and up to 6% of women will …
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