Its cause is not entirely clear; however, it may be linked to food allergies, infections, and medications among others. Prevention
A number of measures have not been confirmed to affect UTI frequency including: urinating immediately after intercourse, the type of underwear used, personal hygiene methods used after urinating or defecating, or whether a person typically bathes or showers. There is similarly a lack of evidence surrounding the effect of holding ones urine, tampon use, and douching. In those with frequent urinary tract infections who use spermicide or a diaphragm as a method of contraception, they are advised to use alternative methods. In those with benign prostatic hyperplasia urinating in a sitting position appears to improve bladder emptying which might decrease urinary tract infections in this group.Using urinary catheters as little and as short of time as possible and appropriate care of the catheter when used prevents catheter-associated urinary tract infections. They should be inserted using sterile technique in hospital however non-sterile technique may be appropriate in those who self catheterize. The urinary catheter set up should also be kept sealed. Evidence does not support a significant decrease in risk when silver-alloy catheters are used. Medications
For those with recurrent infections, taking a short course of antibiotics when each infection occurs is associated with the lowest antibiotic use. A prolonged course of daily antibiotics is also effective. Medications frequently used include nitrofurantoin and trimethoprim/sulfamethoxazole.
Airway management
Airway management has been found to be the most important factor in treating patients with Ludwigs Angina, i.e. it is the “primary therapeutic concern”. Airway compromise is known to be the leading cause of death from Ludwigs Angina. The basic method to achieve this is to allow the patient to sit in an upright position with supplemental oxygen provided by masks or nasal prongs. Patients airway can rapidly deteriorate and therefor close observation and preparation for more invasive methods such as endotracheal intubation or tracheostomy if needed is vital. If the oxygen saturation levels are adequate and antimicrobials have been given, simple airway observation can be done. This is a suitable method to adopt in the management of children, as a retrospective study described that only 10% of children required airway control. However, a tracheostomy was performed on 52% of those affected with Ludwigs Angina over 15 years old. If more invasive or surgical airway control is necessary, there are multiple things to considerFlexible nasotracheal intubation require skills and experience. If nasotracheal intubation is not possible, cricothyrotomy and tracheostomy under local anaesthetic can be done. This procedure is carried out on patients with advanced stage of Ludwigs Angina. Endotracheal intubation has been found to be in association with high failure rate with acute deterioration in respiratory status. Elective tracheostomy is described as a safer and more logical method of airway management in patients with fully developed Ludwigs Angina. Fibre-optic nasoendoscopy can also be used, especially for patients with floor of mouth swellings.