Episode 110. Recurrent UTI with Dr Tony Amin

Urinary tract infections are one of the top twenty reasons patients present, for primary care. According to Kidney Health Australia, 1 in 2 women and 1 in 20 men will develop a urinary tract infection in their lifetime. Approximately 4 in 10 women who develop a UTI will have at least one more infection in the next 6 months. Furthermore, 4% of patients in residential care develop recurrent UTIs, which is defined as 3 infections in a 12-month period or 2 or more in a 6-month period (including cystitis and pyelonephritis).

UTI is the most common cause of septicaemia in the elderly, with a mortality approaching 50%. Although symptoms suggestive of urinary infection are generally well-known including dysuria, frequency, fever, haematuria, etc. Urinary infection should always be considered and searched for in a noncommunicative patient presenting with fever or sepsis. In this regard a point of care dipstick, if possible, followed by formal culture may be most instructive.

Whilst anti-microbial therapy is the mainstay of management… in this podcast, I was also keen to investigate the role of behavioural changes, hygiene, oestrogen, cream, Methenamine Hippurate, and other approaches to holistic care.

I was also curious to learn how our guest approaches the role of post coital antibiotic dosing (up to 2/3 of women are estimated to benefit from this approach) as well as longer term (3-6 month) low dose antibiotic therapy in managing recurrent UTI.

This was a fascinating conversation with a return guest Dr Tony Amin, a renal physician and educator. I’m very grateful to him for joining us once more.

Please welcome Tony to the podcast.

References:

Dr Tony Amin: www.healthshare.com.au

https://www1.racgp.org.au › April, Recurrent UTIs, and cystitis symptoms in women - RACGP

https://www.ncbi.nlm.nih.gov › pmcGuidelines for the diagnosis and management of recurrent urinary tract ...

www.ncbi.nlm.nih.govRecurrent Urinary Tract Infections Management in Women: A review

www.nature.comNonantibiotic prevention and management of recurrent urinary tract infection

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au.

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne, Australia, and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.