a case study on urinary tract infection ( UTI)

A case study on urinary tract infection , which gives a detailed study about UTI , the case study details about the treatment options , diagnosis , patient counselling , pharmacist interventions etc

1. A CASE STUDY ON URINARY TRACT INFECTION Submitted by MARTIN SHAJI Pharm D

2. PATIENT DEMOGRAPHY Patient Name: Mr. X IP No: 31580 Admission date : 21 .03.19. Discharge date: 24 .03.19 Age : 48years Sex : M   Department: General Medicine

3. CHIEF COMPLAINTS: Fever from 3 months on and off, abdominal pain during micturition. HISTORY OF PRESENT ILLNESS: Dysuria and myalgia since 3 months No H/O bleeding, rashes, loose stools, vomiting No H/O cough with expectoration PAST MEDICAL HISTORY : Nothing significant ALLERGY :(food/drug/other) No known allergies.

4. PERSONAL HISTORY AND HABITS : Diet : Mixed. Sleep: normal. Appetite : normal. Bowel and bladder : burning sensation and pain during micturition. FAMILY HISTORY: Nothing significant.

5. General Examination: Conscious and coherent 1. Physical examination: Vital signs: Temperature ( o F ): 101 Pulse rate (/min ): 80beats Respiratory Rate (/min): 25 cycles Blood Pressure (mm of Hg): 150/80mm of Hg 2 . Systems Examination: CVS: S1, S2 + RS: Clear GU &GI (ABDOMEN): Soft

6. 3. Laboratory Data: 1. Hb 14.00g ( 12-15g/ dL ) 2.WBC 12,100 ↑ (4,000-11,000cells/cu.mm ) 3. DC: N 75 40-70% L 35 20-40% E 4 1-6% B 0 <1% M 15 2-10% 4. RBS 115 80-120mg/dl

7. URINE ANALYSIS RESULT Result Reference standard/range Color Yellow; hazy Yellow Specific gravity (g/ml) 1.018 1.005_1.030 Blood Trace Negative Ketone Negative Negative Glucose Negative Negative Bacteria 3+ Non WBC 40-100/hpf 0-5/ hpf

8. URINE CULTURE TEST Isolated bacteria Number of sample Frequency ESCHERICHIA COLI 58 81.69

9. SOAP NOTES SUBJECTIVE EVALUATION: A 50 years old male patient was admitted with the complaints of fever from 3 months on and off, abdominal pain during micturition. Dysuria and myalgia was present since 3 months. Burning sensation and pain during micturition was present. OBJECTIVE EVALUATION: On Examination, the patient was conscious & coherent. BP levels were elevated - 150/80 mmHg Lab data reveals slight elevation in WBC- 12,100 cells/cu.mm ASSESSMENT: Based on subjective & objective evaluation the physician con f irmed it as URINARY TRACT IN F ECTION.

10. DRUG CHART Sl.No . Drug - Indication Dose ROA Frequ-ency Start &End date Brand Name Generic Name 1. T. NORFLOXACIN   T. NORFLOXACIN Antibacterial ( fluoroqquinolones ) 500 mg P/O BD 21/3/19to 24/3/19 2. INJ. PARA   INJ.. Paracetamol Antipyretic & analgesic 150mg IV BD 21/3/19to 24/3/19 3. INJ. RANTAC   INJ. Ranitidine H-2 blocker 25mg   IV   BD 21/3/19to 24/3/19 4. T. BCT   T . B Complex Vitamin supplement 63mg   P/O   OD 21/3/19to 24/3/19 5. INJ. TRAMADOL   INJ. TRAMADOL Opioid analgesic 50mg IV BD 21/3/19to 24/3/19

11. PLANNING On Day-I : Tab. Norfloxacin 500mg P/O BID is used as an Antibiotic. Which may reduce microbial action . Inj. Ranitidine 25mg IV B D is used as an anti-ulcerative drug. Reduce stomach irritation ,do not take more than two weeks. Inj . Paracetamol 150mg IV BID is used as an anti-pyretic. It act as a pain killer and also as temp lower. Inj. Tramadol 50mg IV BID is an opioid analgesic given to reduce the pain. Use twice daily. Tab . B-complex 63mg P/O OD used as a vitamin supplement. Use one tablet in morning and night.

12. PLANNING… On Day-2 & On Day-3: Continue same medication. On Day-4: On fourth day patient was continued with the same medication because of no fresh complaints. As the patient was symptomatically better, he was discharged with the following medications and asked to review after 1 week. Rx, T.Norfloxacin 500mg BID T. Ranitidine 150 mg BID T. Paracetamol 500 mg T ID T. Tramadol 100mg BID T. B-complex 63mg O D

13. PHARMACIST INTERVENTIONS 1. The BP level was elevated but neither treatment nor further BP checkup was done. 2. No DDI or ADRs were found.

14. You should wipe from front to back after urinating or a bowel movement. You should drink plenty of fluids. Drinking cranberry juice may be helpful. Women prone to  UTIs  should avoid using birth control methods such as a contraceptive diaphragm and spermicidal jelly.

15. There are several ways you can prevent UTIs.  You should keep your genital area clean and wear clean, dry cotton underwear.  You should wipe from front to back after urinating or a bowel movement.  You should drink plenty of fluids.  Drinking cranberry juice may be helpful.   Women prone to UTIs should avoid using birth control methods such as a contraceptive diaphragm and spermicidal jelly.  Women should not douche or using similar feminine hygiene products.  Women and girls should avoid bubble bath products.  Bubble baths do not cause a UTI, but they can irritate the urinary tract.    You should urinate after sexual intercourse.  Some women consistently develop UTIs after sexual intercourse.  In these cases, doctors can prescribe an antibiotic that is taken after sexual intercourse as a preventive measure.

16. REGARDING LIFE STYLE MODIFICATIONS: Patient is advised to maintain proper hygiene. Advised to drink plenty of water. Citrus juices should be taken. Limit caffeine intake Avoid OTC preparations. The patient given appropriate advice regarding transmission and re infection.

17. THANK YOU.