Summary of
Consensus Guidelines on Management of Urinary Tract Infection in Pregnancy 2021 (MOH)
1. What are some definitions of UTI?
- Lower urinary tract infection - LUTI
- include acute cystitis, acute urethritis
- asymptomatic bacteriuria (ASB)
- results from untreated LUTI
2. What are the signs and symptoms of UTI in pregnancy?
- dysuria - painful urination
- urgency - unable to hold urine
- increased frequency of urination
3. How to assess someone with possible urinary tract infection in pregnancy?
- no need to screen those without symptoms
- those with symptoms, can use reagent strip test
- nitrite +ve : treat with antibiotic
- nitrite -ve, leucocyte -ve : unlikely UTI
- nitrite -ve, leucocyte +ve
- if symptoms suggestive of UTI, treat with antibiotic
4. How to treat UTI in pregnancy
- for ASB or UTI with symptoms, treat with one of the following antibiotics for 5-7 days
- nitrofurantoin 50-100mg QID (avoid in 3rd trimester)
- trimethoprom / sulphmethoxazole 160/8000mg BD
- require admission to hospital
- treat with one of the following IV antibiotics, usually for 10-14 days
- Ampicillin / sulbactam 1.5-3g TDS (Unasyn)
- take a follow up urine culture 1-2 weeks after completion of treatment, then another one in 3rd trimester
5. What are non pharmacological management of UTI in pregnancy
- wash the genital area after sex
- void the bladder after sex
- wipe the genital area after voiding from front to back direction (not back to front)
- can recommend for those high risk
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