The full content of Annals is available to subscribers

Subscribe/Learn More  >
Diagnosis and Treatment |

Urinary Tract Infections in Women: Diagnosis and Treatment

James R. Johnson, MD; and Walter E. Stamm, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Walter E. Stamm, MD, Infectious Diseases ZA-89, Harborview Medical Center, Seattle, WA 98104.

Current Author Addresses: Dr. Johnson: Department of Medicine, Box 250, University of Minnesota Hospital and Clinics, Minneapolis, MN 55455.

Dr. Stamm: Infectious Diseases ZA-89, Harborview Medical Center, Seattle, WA 98104.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(11):906-917. doi:10.7326/0003-4819-111-11-906
Text Size: A A A

Acute urinary tract infection is a major health problem among women, accounting for considerable morbidity and health care costs. We review recent developments in the diagnosis and treatment of these infections. In acute lower urinary tract infection, empiric short-course therapy (single-dose or 3-day therapy) with one of several antibiotics is recommended in the absence of complicating factors. When complicating factors are present, the antibiotic susceptibility profile of the infecting organism should be determined and therapy with an appropriate agent should be provided for 7 days. Ampicillin and related drugs are probably inferior to trimethoprim-sulfamethoxazole in the treatment of occult renal infection. In acute pyelonephritis, most patients require hospitalization and treatment with intravenous antibiotics until they can take oral medications. In uncomplicated cases, a single broad-spectrum intravenous agent can be used initially, followed by an oral agent selected on the basis of antibiotic-susceptibility testing results. Patients with uncomplicated acute pyelonephritis who are less ill can be managed with oral therapy as outpatients, again with reference to the results of antibiotic-susceptibility testing. Complicated acute pyelonephritis requires more aggressive diagnostic and therapeutic measures. Therapy for uncomplicated acute pyelonephritis should be given for 14 days. The role of post-therapy cultures in the management of urinary tract infection is not well defined, but cultures probably can be safely omitted in most cases of uncomplicated acute cystitis.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Journal Club
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.