Title: Recurrent Urinary Tract Infections and Lithium Therapy: A Case Report on Treatment Considerations

Authors: Dr Omar Kasmieh, Dr Raed Azzam, Dr Mustafa Salah

 DOI: https://dx.doi.org/10.18535/jmscr/v12i12.08

Abstract

Lithium is a medication often used in multiple psychiatric conditions. Lithium salts have a limited therapeutic window, necessitating caution in prescribing and requiring adequate monitoring of serum lithium levels. Several factors can impact lithium concentration, including changes in diet and fluid intake, illness, and adherence to treatment. The half-life of lithium is approximately 24 hours and is longer in cases of renal impairment. Lithium should be initiated in secondary healthcare settings. After initiation, patients are managed under a shared care protocol to monitor lithium levels and kidney function.

Primary healthcare doctors serve as gatekeepers for these patients; high suspicion and sufficient knowledge about the signs and symptoms of lithium toxicity are mandatory to avoid toxicity and to ensure early involvement of secondary care assessment. This case highlights the importance of regular monitoring of medications like lithium and for family physicians to be mindful of any conditions that may impact lithium levels, such as recurrent urinary tract infections, which affect the kidneys. It also emphasizes the need to consider other treatment options that are not influenced by renal function.

Keywords: bipolar disorder, lithium toxicity, monitoring lithium, recurrent Urinary tract infection, consideration of other treatment.

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Corresponding Author

Omar Kasmieh

Tuakau Health Centre, New Zealand