Urinary tract infections and the urethral syndrome in adult women: pathogenesis, diagnosis, and therapy.

Urinary infections in adult women are extremely common. Yet, dysuria, often a symptom of these infections, can be caused by a number of genitourinary pathogens. Symptomatic urinary infections caused primarily by Escherichia coli or Staphylococcus saprophyticus are best confirmed by demonstrating the presence of 10(2) or more organisms per ml of midstream urine in quantitative cultures. Other causes of dysuria such as vaginitis and urethritis due to venereal disease should be suspected in patients with additional signs and symptoms characteristic of these infections and in young, sexually active females. Effective treatment of urinary infections is achieved with a number of antibiotics; the length of therapy is determined by the location of infection in the urinary tract. Although equal in efficacy to conventional therapy for uncomplicated lower tract infections, single-dose therapy of dysuric women should be limited to patients for whom adequate follow-up can be insured.