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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 ]
A review from 2019 indicated that antibiotics may reduce symptoms. Some have found benefits in symptoms, [64] [65] but others have questioned the utility of a trial of antibiotics. [66] Antibiotics are known to have anti-inflammatory properties and this has been suggested as an explanation for their partial efficacy in treating CPPS. [25]
Chronic bacterial prostatitis is thought to be caused by ascending urethral infection and by reflux into the ejaculatory duct or prostatic ducts. [7] Risk factors for chronic bacterial prostatitis include functional or anatomic abnormalities, catheterization, prostate biopsy or urethritis (due to sexually transmitted infections), and unprotected penetrative anal sex. [7]
TMP/SMX is commonly used due to its ability to achieve high concentrations in urinary tract tissues and urine. This antibiotic combination demonstrates notable efficacy in both the treatment and prophylaxis of recurrent urinary tract infections. [12] Common adverse effects include nausea, vomiting, rash,pruritus, and photosensitivity. [26]
It usually manifests in 1–3 hours after the first dose of antibiotics as fever, chills, rigor, hypotension, headache, tachycardia, hyperventilation, vasodilation with flushing, myalgia (muscle pain), exacerbation of skin lesions and anxiety. The intensity of the reaction indicates the severity of inflammation.
Treatment is based on the prescription and use of the proper antibiotics depending on the strain of the ureaplasma. [ 7 ] Because of its multi-causative nature, initial treatment strategies involve using a broad range antibiotic that is effective against chlamydia (such as doxycycline ).
If no abnormality is identified, some studies suggest long-term preventive treatment with antibiotics, either daily or after sexual activity. [26] In children at risk for recurrent urinary tract infections, not enough studies have been performed to conclude prescription of long-term antibiotics has a net positive benefit. [27]
Large studies of patients have also failed to show any correlation between lower urinary tract symptoms and a specific diagnosis. [11] Also, recently a report of lower urinary tract symptoms even with malignant features in the prostate failed to be associated with prostate cancer after further laboratory investigation of the biopsy. [10]
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