Urinary Tract Infections

Abstract

THE DIAGNOSIS and management of urinary tract infection rests on two major concepts. The first,significant bacteriuria, provides the basis for definitive diagnosis, efficacy of therapy, and follow-up. Until recently, it was relatively expensive to test for significant bacteriuria. Also, results were often available only after the physician had had to make a therapeutic commitment. Significant bacteriuria can now be detected by excellent, inexpensive office methods, including microscopic examination of the urine and quantitative culture. In addition, there now are commercially available chemical tests, which when properly used should be helpful for both screening and follow-up. The second major concept is atherapeutic conceptthat divides urinary tract infection into the so-calledcomplicated(or surgical) anduncomplicated(or medical) categories of infection. It is relatively easy to treat infection uncomplicated by structural or neurologic lesions. Numerous effective antimicrobial agents are useful both for treatment and prophylaxis. Furthermore, antimicrobial sensitivity tests