Case presentation On Urinary tract infection

Urinary tract infection case study

1. CASE PRESENTATION on URINARY TRACT INFECTION S. Karthikeyan PHARM D Intern 18408111

2. URINARY TRACT INFECTION A urinary tract infection, or UTI, is an infection in any part of the urinary system, which includes kidneys, bladder, ureters, and urethra. UTI is a symptomatic presence of microorganisms within the urinary tract i.e., kidney, bladder and urethra. Which is associated with the inflammation of urinary tract.

3. TYPES: URETHRITIS - infection of urethra CYSTISIS - infection to urinary bladder PYELONEPHRITIS - infection of one / both the kidneys UTIs are caused ny microorganisms usually bacteria.the different types of UTIs are: They are further classified as, Uncomplicated UTIs : without any underlying renal diseases. Complicated UTIs : with the underlyin structural, medical, or neurological diseases. Recurret : <3 symptomtic UTIs within 12 months following clinical therapy

4. RISK FACTORS Some are at greater risk of developing UTIs. These includes, Women- shorter urethra close to the openings, pregnancy, decrease in estrogen levels Men with prostate complications Newborns- congenital abnormalities. sexual intercourse History of recurrent UTIs Ageing: urinary retention, diabetes, impaired immune system, catheterization

5. CASE STUDY

6. A 29 years old, female patient was admitted 29 /0 1 /202 4 with CHIEF COMPLAINTS : C/o back pain radiating to urethra c/o painful urination HISTORY OF PRESENT ILLNESS: Difficulty in urination Fever for past 2 days No h/o of menstrual disturbances DOA: 29 /0 1 /2 4 DOD: 4/ 02 /2 4

7. PAST MEDICAL HISTORY : not a Known case of bronchial asthma/TB/DM/HT/Allergy OBSESTRIC HISTORY: P2L2, NVD, ST done, LMP- 8/8/23 SURGICAL HISTORY: NIL On general examination patient is conscious, oriented, afebrile, not pallor HR: 82 Beats/min BP: 110/80 mmHg RR: 22 Breaths / min SPO2: 99% On systemic examination : CVS: NAD CNS: NFND RS: NAD P/A: Soft , right loin tenderness.

8. LAB INVESTIGATIONS PARAMETERS OBSERVED VALUE NORMAL VALUE HAEMOGLOBIN 12.4 g/dl 11 to 16 g/dl R.B.C 4.37 millions/ cmm 3.6 to 5.5 millions/ cmm PLATLET COUNT 3.84 lakhs/ cmm  1-4 lakhs M.C.H 29.4 Pg 27-31 Pg PCV 34.2 % 40-50% WBC 10,100cells/ cmm 4000-11000cells/ cmm RBS 97 70-140mg/dl

9. LAB INVESTIGATIONS PARAMETERS OBSERVED VALUE NORMAL VALUE BLOOD UREA 24 mg /dL 15- 40 mg / dL S.CREATININE 0.6mg/dL 0.4 to 1.3 mg/dL S.BILURUBIN – TOTAL 0.4mg/dL <1.0mg/ dL BILIRUBIN – DIRECT 0.2mg/dL <0.2mg/ dL S.G.O.T 22 U/L Upto 35U/L S.G.P.T 35 U/L Upto 40U/L ALKALINE PHOSPHTASE 60 U/L 40-130 U/L TOTAL PROTEIN 7.0g/dL 6.0-8.0g/Dl ALBUMIN 4.2g/dL 3.5-5.0g/dL HbSAg Negative

10. DIAGNOSIS : URINARY TRACT INFECTION

11. DRUG CHART BRAND NAME GENERIC NAME DOSE ROA FREQUENCY &DURATION CATEGORY INJ.TAXIM CEFOTAXIME 1 gm IV BD( 29/9/23 to 3/10/23 ) 3 rd generation cephalosporins antibiotics T.URISPAS FLAVOXATE HCL 200MG P/O BD( 29/9/23 to 3/10/23 ) Anti-spasmodic T.PARA PARACETAMOL 500mg P/O TDS( 29/9/23 to 3/10/23 ) Analgesic C.PAN PANTOPRAZOLE 40mg P/O BD( 29/9/23 to 3/10/23 ) PPI INJ.DICYCLOMINE DICYCLOMINE HCL 1amp(2ml) IM BD( 29/9/23 to 30/9/23 ) Antispasmodic T.NORFLOX NORFLOXACIN 400MG P/O BD( 29/9/23 to 1/10/23 ) Fluoroquinolones antibiotics SYP.CITRALKA DISODIUM HYDROGEN CITRATE 10ML P/O BD( 29/9/23 to 3/10/23 ) Urine alkalizer

12. BRAND NAME GENRIC NAME DOSE ROA FREQUENCY&DURATION CATEGORY T.CEFIXIME cefixime 200mg P/O 1-0-1 Antibiotic T.PAN Pantoprazole 40mg P/O 1-0-1 1 week PPI T.URISPAS Flavoxate hcl 200 mg P/O 1-0-1 Anti-spasmodic SYP.CITRALKA Disodium hydrogen citrate 10ML P/O 1-1-1 Urine alkalizer DISCHARGE MEDICATIONS:

13. DRUG-DRUG INTERACTIONS: No drug-drug interactions found.

14. CLINICAL PHARMACIST INTERVENTION The treatment given to the patient was almost relevant and the condition of the patient was improved at the time of discharge But apart from this there are some instead are, Antimicrobial therapy should be prescribed after the identification of microorganism via Culture sensitivity test. In this case, Emprically initiated Antibiotic therapy has been Continued without identifying the Microorganism which is irrelevant. Differential WBC count Has not been done

15. PATIENT COUNSELING Drink plenty of water and other fluids to flush the urinary system Avoid using spermicide containing products particularly with diaphragm contraceptive device Rather holding on urinate often Maintain proper hygiene Wipe from front to back after using toilet. Empty your bladder after sexual intercourse Avoid constipation. Consume Cranberry juice which is promoted to prevent or treat UTIs. citrus juices also be helpful.

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