DISORDERS OF THE KIDNEYS, BLADDER, AND PROSTATE
BLADDER INFECTION
Treatment involves the administration of an antibiotic and increased oral fluid intake. Because many antibiotics are well concentrated in the urine, there are a number of acceptable treatment regimens. For the sake of simplicity, the female victim may be treated with trimethoprim-sulfamethoxazole (Bactrim or Septra) in one double-strength tablet twice a day for 3 days, or two double-strength tablets in one dose; ciprofloxacin 250 mg twice a day for 3 days, or 500 mg in one dose; ofloxacin 200 mg twice a day for 3 days, or 400 mg in one dose; norfloxacin 400 mg twice a day for 3 days; lomefloxacin 400 mg, trovafloxacin 100 mg, or levofloxacin 250 mg once a day for 3 days; cefpodoxime 100 mg twice a day for 7 days; amoxicillin-clavulanate 500 mg/125 mg twice a day for 7 days; nitrofurantoin monohydrate/macrocrystals (Macrobid) 100 mg capsule twice a day for 7 days with meals; nitrofurantoin macrocrystals 50 to 100 mg four times a day for 7 days; or fosfomycin tromethamine (Monurol) 3 g in a single dose. If the victim is diabetic or older than 65 years of age, or if the symptoms do not completely resolve or they recur within a few days of therapy, use the same or a different drug for 7 to 10 days. If the victim is pregnant, use amoxicillin, ampicillin, nitrofurantoin, cephalexin, cefadroxil, or trimethoprim-sulfamethoxazole.
Chlamydia are bacterium-like “germs” that are increasingly the cause of reproductive tract infections in women and genitourinary tract infections in men. Because the penicillins (such as ampicillin) are not effective against Chlamydia, any male with a bladder infection should be treated with tetracycline (500 mg four times a day), doxycycline (100 mg twice a day), or trimethoprim-sulfamethoxazole (one double-strength tablet twice a day) for 10 days, or with azithromycin 1 g in a single dose. Any male who develops a bladder or prostate infection (see page 297) should be seen by a physician when he returns from his journey.
