A urinary tract infection (UTI) is a bacterial infection that occurs anywhere in the urinary tract, including the kidneys, ureters, bladder, and urethra. Here's a detailed explanation of urinary tract infections in four steps: Cause and Risk Factors: UTIs are typically caused by bacteria, most commonly Escherichia coli (E. coli) which is found in the digestive system. However, other bacteria such as Klebsiella and Staphylococcus saprophyticus can also cause UTIs. UTIs can occur when bacteria enter the urinary tract through the urethra and multiply in the bladder. Risk factors for developing UTIs include: Female anatomy: Women have a shorter urethra than men, making it easier for bacteria to reach the bladder. Sexual activity: Sexual intercourse can introduce bacteria into the urinary tract. Certain types of birth control: Diaphragms and spermicides can increase the risk of UTIs. Menopause: Decreased estrogen levels can lead to changes in the urinary tract that increase susceptibility to infections. Urinary tract abnormalities: Conditions such as kidney stones or an enlarged prostate can obstruct the flow of urine, increasing the risk of UTIs. Symptoms: The symptoms of a UTI can vary depending on which part of the urinary tract is affected. Common symptoms include: Pain or burning sensation during urination (dysuria) Frequent urination Urgency to urinate Blood in the urine (hematuria) Cloudy or strong-smelling urine Pelvic pain in women Rectal pain in men Symptoms of a UTI in the elderly or individuals with weakened immune systems may be less specific and may include confusion or agitation. Diagnosis: Diagnosis of a UTI typically involves a medical history, physical examination, and laboratory tests. A urine sample may be collected to test for the presence of bacteria, white blood cells, or other indicators of infection. In some cases, a urine culture may be performed to identify the specific bacteria causing the infection and determine which antibiotics are most effective for treatment. Imaging tests such as ultrasound or CT scans may be ordered if there is suspicion of complications such as kidney infection or urinary tract obstruction. Treatment and Prevention: Treatment for UTIs usually involves antibiotics to eliminate the bacteria causing the infection. The choice of antibiotic and duration of treatment may vary depending on the severity of the infection, the specific bacteria involved, and any underlying health conditions. In addition to antibiotic therapy, drinking plenty of fluids and urinating frequently can help flush bacteria from the urinary tract. Preventive measures for UTIs include: Drinking plenty of water to stay hydrated Urinating soon after sexual intercourse Wiping from front to back after using the toilet Avoiding the use of irritating feminine products or douches Taking showers instead of baths Cranberry products may help prevent recurrent UTIs in some individuals by preventing bacteria from adhering to the uti

1. CASE STUDY ON UTI COMPLICATED
BY,
SRIRAMTHIRUNAVUKKARASU,
PHARM D IIIrd YEAR,
PGP COLLEGE OF PHARMACY,
NAMAKKAL.

2. CASE SUMMARY
• A 51 years old female patient was admitted to the Hospital with the chief complaints of Chest pain,
Sweating and palpitation for 5 days.
• She has a present medical history of Right shoulder pain, Sweating, Palpitation for 5 days.
• She has no Past Medical History, Social and Allergy history.
• The patient had increased level of RBS, Platelet. He has decreased value of S. Creatinine,
Hemoglobin and HDL.
• She was diagnosed with Anterior wall MI, Anemia, Coronary Heart Disease, AFI- Viral.
• Inj. Enoxaparin, T. Paracetamol, T. Ceftriaxone + Sulbactam, T. Pantoprazole, T. Glyceryl trinitrate, T.
Atorvastatin, T. Ramipril, T. Alprazolam, T. Metoprolol, T. Aspirin + Clopidogrel, Syp.Mg(OH) were
given to the patient during hospitalization.
•She was discharge on 10.01.2022.

3. UTI (URINARY TRACT INFECTION)
DEFINITION
• The World Health Organization (WHO) defines a urinary tract infection (UTI) as an infection that
can occur in any part of the urinary system, which includes the kidneys, bladder, ureters, and
urethra. UTIs are usually caused by bacteria entering the urinary tract and multiplying, leading to
infection.
• UTIs are usually caused by bacteria entering the urinary tract and multiplying, leading to infection.
Common symptoms of a UTI may include a strong, persistent urge to urinate, a burning sensation
when urinating, passing frequent, small amounts of urine, cloudy, dark, bloody, or strong-smelling
urine, pain or pressure in the lower abdomen or back, and feeling tired or shaky.

4. PATHOPHYSIOLOGY

5. SOAP ANALYSIS

6. SUBJECTIVE
•A 62 years old male patient was admitted in the Hospital with the chief complaints of giddiness,
increased urine frequency, H/O of fever and cough, cathing sensation in bilateral lower limb, no back
ache, no pedal edema.
• He also unable to walk. He has Not known case of Hypertension and Diabetes mellitus.
• He has no Past Medical and medication History.
•He has no Social history and known drug Allergies.

7. • The patient was conscious, Oriented and febrile.
• No head injury,
• Eye movement normal,
• CVS - S1S2 Normal,
• RS - NVBS Normal,
• CNS – NFND,
• GIT- P/A – Soft,
•GCS- 15/15, ECOG- 2.
OBJECTIVE
On Physical Examination,

8. S. NO PARAMETERS DAY 1 DAY 2 DAY 3 DAY 4 NORMAL RANGE
1. TEMPERATURE (F) 103 101.2 98 98 97.2-98.8 F
2.
BLOOD PRESSURE
mmHg
110/70 150/90 140/90 120/60 120/80mmHg
3.
PULSE RATE
Beats/min
110 118 82 82
60-100Beats/min
4.
RESPIRATORY RATE
breaths/ min
20 20 20 18
12-16
BREATHS/MIN
5. SPO2 98% 98% 98% 99% 95-100%
VITAL SIGNS :-

9. Laboratory Values:-
LAB INVESTIGATION DAY-1 NORMAL VALUES
FULL BLOOD COUNT
Hb 12.1 12-15 g/dL
RBC 4.25 4-5.65 million cells/cu.mm
Platelet 192000 150000 - 450000 cells/µL
WBC 7760 4,500 to 11,000 /microliter
BLOOD UREA 23.3 5 to 20 mg/dl
RENAL PROFILE
S. Creatinine 1.17 0.7-1.2 mg/dL
OTHER
RBS 122.2 75-125mg/dl

10. ASSESSMENT :-
Diagnosis,
• Based on the Laboratory values and Vital signs monitored as per test the patient shows elevated
Blood pressure, respiratory rate, pulse rate, hyperthermia and increased Sr. creatinine.
• The patient diagnosed with UTI COMPLICATED.

11. PLAN
Goals Of Therapy,
 To reduce fever,
 To treat bacterial infection.
 To reduce blood pressure.

12. TREATMENT CHART:-
DRUG DOSE ROA FREQUENCY DAY 1 DAY 2 DAY 3 DAY 4
Inj. Cefrtriaxone + sulbactum 1.5 g IV BD  - - -
Inj.Ondansetron 8 mg IV BD    
Inj. Amikacin 750 g IV BD    
Inj. Meropenem 1g IV BD    
Inj. Ketorolac tramadol 30mg IV BD    
Inj. Pantoprazole 40 mg IV BD    
T. Betahistine 16mg P/O BD    
Tab. Ibuprofen + paracetamol 400+325mg P/O BD    
T. Domperidone+ cinnarizine 15+20 mg P/O BD    

13. DISCHARGE MEDICATION
 Continue the medication until revisit after 4 days
S.NO DRUG DOSE FREQUENCY DURATION
1. T.FEROPENEM 200mg BD 4 days
2. T. DOMPERIDONE+PANTOPRAZOLE 30+40mg OD 4 days
3. T. FLAVOXATE HCl 200mg OD 4 days
4. T.TAMSULOSIN+DUTASTERIDE 0.4mg OD 4 days
5. T. DOMPERIDONE +CINNARIZINE 15+20mg BD 4 days
6. T. IBUPROFEN+ PARACETAMOL 400+ 325mg BD 4 days

14. PATIENT COUNSELLING
S.NO DRUG- 1 DRUG-2 INTERACTIONS PHARMACIST
RECOMMEND
ATION
1. T. IBUPROFEN Inj. Ketorolac
Either increases the toxicity
of other by addition effect.
Ibuprofen
should be
avoided, drug
etoricoxib can
be prefferd
2. T. IBUPROFEN Inj. Ketorolac
Both increases side effect
and causes bleeding or
brushing, both increases
the potassium level
3. T. IBUPROFEN Inj.Amikacin
Drug 1 increases drug 2 by
reducing drug clearance
through kidney.

15. PATIENT COUNSELLING
Drug based Counselling:
 Don’t skip any dose.
 Continue medication until revisit.
 T. Pantoprazole should be taken 30 minutes before food.
 Tab. Faropenem should be taken on an empty stomach,
about 1 hour before or 2 hours after a meal, with a full glass of water..
Disease based Counselling:
 UTI is the infection of the urinary tract. It is mainly caused by bacteria.

16. Lifestyle based Counselling:
Diet based Counselling:
 Take rich source of vitamin c (citrus fruits like lemon, orange etc….)
 Add yogurt in the diet.
 Avoid coffee and also avoid spicy and processed foods.
 Practice good hygiene.
 Use clean rest rooms and sanitize you-self properly.
 Avoid tight fitting cloths.
 Urinate properly.

17. PHARMACIST INTERVENTION
 The given prescription is irrational with minor drug interactions.

18. THANK YOU