Urinary tract infections may involve the upper or lower urinary tract. Infections may be complicated or uncomplicated. Uncomplicated cystitis is a lower UTI in a non-pregnant woman of reproductive age and who has a normal urinary tract. All other UTIs should be regarded as complicated. The commonest causative pathogens for UTIs irrespective of the group of patients involved in Tanzania are Escherichia coli, Klebsiella pneumonia, Proteus spp. and Staphlococcus aureus.

Non-pharmacological tTreatment

• Ensure adequate hydration

• Encourage voiding of urine whenever there is an urge to micturate or after sexual intercourse in adults

• Remove indwelling bladder catheter where indicated

Symptomatic treatment

Analgesics for severe dysuria and flank pain

Adults

• Paracetamol (PO) 500–1000 mg every 6–8 hours

Children

• Paracetamol (PO) 15 mg/kg/dose every 4–6 hours when required

• Maximum of 4 doses per 24 hours

Management of uncomplicated cystitis

Adults

• Nitrofurantoin (PO) 100 mg 12 hourly for 5 days OR Flucloxacillin + Amoxicillin (FDC) (PO) 500 mg 8 hourly for 5 days

Children

• Nitrofurantoin (PO) 50 mg 12 hourly for 5 days

  • Do not give Nitrofurantoin if the child has G6PD deficiency or porphyria

    
    

    OR

• Amoxicillin + Clavulanic acid (FDC) (PO) 40 mg/kg/day of amoxicillin in 3 divided doses

  • Maximum dose: 2000 mg amoxicillin

  • Duration: 7 days