Prescription format of case of fever + burning sensation

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prescription format fever burning sensation UTI sample India

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I now have all the information needed to write a complete, well-structured prescription format. Here it is:

Prescription Format: Fever + Burning Sensation (Presumed UTI / Dysuria)

Clinical Impression: Acute Uncomplicated Cystitis (UTI) - Fever + Dysuria/Burning Micturition

🩺 Prescription

Dr. [Name], MBBS/MD
Reg. No.: [Registration Number]
[Clinic/Hospital Name, Address]
Date: __ / __ / ______

Patient Name: ___________________   Age: ___   Sex: M / F
Weight: ___ kg                       IP/OP No.: _________

Dx / Clinical Impression: Acute Urinary Tract Infection (Cystitis)
Symptoms: Fever, Dysuria (Burning Micturition), Frequency

─────────────────────────────────────────────────────
℞
─────────────────────────────────────────────────────

1. Tab. Paracetamol 500 mg
   1 tab orally TDS (three times daily) × 5 days
   (Take after food. For fever & pain relief.)

2. Tab. Norfloxacin 400 mg + Tinidazole 600 mg
   1 tab orally BD (twice daily) × 5–7 days
   (Take on empty stomach or as directed.)
   ── OR ──
   Tab. Ciprofloxacin 500 mg
   1 tab orally BD × 3–5 days
   (Preferred if local resistance pattern allows)
   ── OR ──
   Tab. Nitrofurantoin (Macrobid) 100 mg
   1 tab orally BD × 7 days
   (Good choice in uncomplicated UTI; avoid if CrCl < 30)

3. Tab. Phenazopyridine 200 mg
   1 tab orally TDS × 2–3 days
   (Urinary analgesic for burning relief; urine will turn orange)

4. Sachet ORS / Electrolyte Oral Solution
   1 sachet in 200 mL water, TDS × 3 days
   (For hydration with fever)

─────────────────────────────────────────────────────
Investigations Advised:
  • Urine Routine & Microscopy (Urine R/M)
  • Urine Culture & Sensitivity (C/S) — if recurrent or not improving in 48 hrs
  • CBC + CRP (if high-grade fever / pyelonephritis suspected)

─────────────────────────────────────────────────────
Advice / Instructions:
  • Increase fluid intake (water ≥ 2–3 L/day)
  • Avoid spicy/oily food
  • Maintain perineal hygiene
  • Complete the antibiotic course even if symptoms improve
  • Return immediately if: high-grade fever (>39°C), chills, loin/flank pain, vomiting
    (these may suggest upper UTI / pyelonephritis — needs parenteral therapy)

─────────────────────────────────────────────────────
Follow-up: After 3–5 days, or earlier if not improving

                           Signature: _______________
                           Stamp & Reg. No.

Key Drug Notes

Drug	Dose	Duration	Notes
Paracetamol	500–1000 mg TDS	3–5 days	Antipyretic + analgesic
Ciprofloxacin	250–500 mg BD	3 days	First-line fluoroquinolone
Nitrofurantoin	100 mg BD	7 days	Good for uncomplicated bladder UTI only
TMP-SMX (Cotrimoxazole)	160/800 mg BD	3 days	Use if local resistance <20%
Norfloxacin	400 mg BD	3–5 days	Urinary tract specific quinolone
Fosfomycin	3 g single dose	Single dose	Convenient; useful in pregnancy
Phenazopyridine	200 mg TDS	Max 2 days	Symptom relief only, not antibiotic

Differential Diagnosis to Keep in Mind

Fever + Burning micturition (dysuria) = most likely Cystitis (lower UTI)
Fever + Flank pain + Rigors = Pyelonephritis (upper UTI) - needs IV antibiotics + hospitalization
Burning without fever in women = may be Vaginitis - different management
Burning sensation not urinary (e.g., skin, GERD, neuropathy) = different prescription entirely

Sources:

Textbook of Family Medicine 9e, Table 40-18 - Treatment Options for Acute Uncomplicated UTI
Goldman-Cecil Medicine, Table 263-5 - Cystitis vs. Pyelonephritis diagnosis & treatment
Schwartz's Principles of Surgery - UTI/Cystitis treatment protocols

Note: Always adjust antibiotic choice based on local antibiogram/resistance patterns. Quinolone resistance is rising in many regions (especially South Asia). Culture-guided therapy is preferred for recurrent or complicated UTI.

Create a quick reference PDF of antibiotic dosages for UTI/dysuria

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Running Command

mkdir -p /home/daytona/workspace/uti-pdf && ls /home/daytona/workspace/uti-pdf/

Writing File

~/uti-pdf/generate_uti_pdf.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import mm
from reportlab.platypus import (
    SimpleDocTemplate, Table, TableStyle, Paragraph, Spacer,
    HRFlowable, KeepTogether
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_RIGHT
from reportlab.platypus import Image
import os

OUTPUT = "/home/daytona/workspace/uti-pdf/UTI_Antibiotic_Quick_Reference.pdf"

# ── Colour palette ──────────────────────────────────────────────────────────
DARK_BLUE   = colors.HexColor("#1A3A5C")
MED_BLUE    = colors.HexColor("#2E6DA4")
LIGHT_BLUE  = colors.HexColor("#D6E8F7")
TEAL        = colors.HexColor("#0D7377")
LIGHT_TEAL  = colors.HexColor("#D0EFEF")
ORANGE      = colors.HexColor("#E07B30")
LIGHT_ORANGE= colors.HexColor("#FDEBD0")
RED         = colors.HexColor("#C0392B")
LIGHT_RED   = colors.HexColor("#FADBD8")
GREEN       = colors.HexColor("#1E8449")
LIGHT_GREEN = colors.HexColor("#D5F5E3")
YELLOW_BG   = colors.HexColor("#FDFAE3")
GREY_BG     = colors.HexColor("#F2F2F2")
WHITE       = colors.white
BLACK       = colors.black

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    leftMargin=15*mm, rightMargin=15*mm,
    topMargin=15*mm, bottomMargin=15*mm
)

W, H = A4
usable_w = W - 30*mm

styles = getSampleStyleSheet()

def S(name, **kw):
    base = styles[name] if name in styles else styles["Normal"]
    return ParagraphStyle(name + str(id(kw)), parent=base, **kw)

title_style   = S("Normal", fontSize=20, textColor=WHITE, fontName="Helvetica-Bold",
                  alignment=TA_CENTER, spaceAfter=2)
sub_style     = S("Normal", fontSize=10, textColor=LIGHT_BLUE, fontName="Helvetica",
                  alignment=TA_CENTER, spaceAfter=0)
date_style    = S("Normal", fontSize=8, textColor=LIGHT_BLUE, fontName="Helvetica-Oblique",
                  alignment=TA_RIGHT)

section_style = S("Normal", fontSize=11, textColor=WHITE, fontName="Helvetica-Bold",
                  alignment=TA_LEFT, leftPadding=6)
body_style    = S("Normal", fontSize=8.5, fontName="Helvetica", textColor=BLACK,
                  leading=13, spaceAfter=3)
bold_style    = S("Normal", fontSize=8.5, fontName="Helvetica-Bold", textColor=BLACK)
small_style   = S("Normal", fontSize=7.5, fontName="Helvetica", textColor=colors.grey)
note_style    = S("Normal", fontSize=8, fontName="Helvetica-Oblique",
                  textColor=colors.HexColor("#5D4037"), leading=11)
warn_style    = S("Normal", fontSize=8, fontName="Helvetica-Bold",
                  textColor=RED)
green_style   = S("Normal", fontSize=8, fontName="Helvetica-Bold", textColor=GREEN)
cell_style    = S("Normal", fontSize=8, fontName="Helvetica", textColor=BLACK,
                  leading=11)
cell_bold     = S("Normal", fontSize=8, fontName="Helvetica-Bold", textColor=BLACK,
                  leading=11)
cell_hdr      = S("Normal", fontSize=8.5, fontName="Helvetica-Bold", textColor=WHITE,
                  alignment=TA_CENTER, leading=12)

elements = []

# ── HEADER BANNER ────────────────────────────────────────────────────────────
header_data = [[
    Paragraph("UTI / DYSURIA", title_style),
    Paragraph("Antibiotic Quick Reference Card", sub_style),
    Paragraph("Date: July 2026", date_style),
]]
header_table = Table([[
    Paragraph("UTI / DYSURIA — Antibiotic Quick Reference", title_style),
]], colWidths=[usable_w])
header_table.setStyle(TableStyle([
    ("BACKGROUND",   (0,0), (-1,-1), DARK_BLUE),
    ("TOPPADDING",   (0,0), (-1,-1), 10),
    ("BOTTOMPADDING",(0,0), (-1,-1), 8),
    ("LEFTPADDING",  (0,0), (-1,-1), 12),
    ("ROUNDEDCORNERS", [6]),
]))
elements.append(header_table)

sub_banner = Table([[
    Paragraph("Based on IDSA/ESCMID guidelines &amp; Family Medicine evidence | For uncomplicated UTI in non-pregnant adults", sub_style),
]], colWidths=[usable_w])
sub_banner.setStyle(TableStyle([
    ("BACKGROUND",   (0,0), (-1,-1), MED_BLUE),
    ("TOPPADDING",   (0,0), (-1,-1), 4),
    ("BOTTOMPADDING",(0,0), (-1,-1), 4),
]))
elements.append(sub_banner)
elements.append(Spacer(1, 6))

# ── SECTION HEADER helper ────────────────────────────────────────────────────
def section_header(text, color=MED_BLUE):
    t = Table([[Paragraph(text, section_style)]], colWidths=[usable_w])
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,-1), color),
        ("TOPPADDING",    (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ]))
    return t

# ── 1. CLINICAL DIFFERENTIATION TABLE ────────────────────────────────────────
elements.append(section_header("1.  CLINICAL DIFFERENTIATION: Cystitis vs Pyelonephritis"))
elements.append(Spacer(1, 3))

diff_headers = [
    Paragraph("Feature", cell_hdr),
    Paragraph("Cystitis (Lower UTI)", cell_hdr),
    Paragraph("Pyelonephritis (Upper UTI)", cell_hdr),
]
diff_rows = [
    ["Fever",          "Absent / low-grade",    "Present (>38.5°C), chills"],
    ["Dysuria",        "Yes (hallmark)",         "May be present"],
    ["Frequency",      "Yes",                    "May be present"],
    ["Flank / Loin pain","No",                   "Yes (hallmark)"],
    ["Nausea / vomiting","Absent",               "Common"],
    ["CRP",            "Normal",                 "Elevated"],
    ["Blood cultures", "Negative",               "Positive in 10-30%"],
    ["Route of Rx",    "Oral antibiotics",       "IV then oral step-down"],
]

diff_table_data = [diff_headers]
for r in diff_rows:
    diff_table_data.append([
        Paragraph(r[0], cell_bold),
        Paragraph(r[1], cell_style),
        Paragraph(r[2], cell_style),
    ])

col1 = usable_w * 0.26
col2 = usable_w * 0.37
col3 = usable_w * 0.37

diff_table = Table(diff_table_data, colWidths=[col1, col2, col3])
diff_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), TEAL),
    ("BACKGROUND",    (0,1), (-1,1), LIGHT_TEAL),
    ("BACKGROUND",    (0,2), (-1,2), WHITE),
    ("BACKGROUND",    (0,3), (-1,3), LIGHT_TEAL),
    ("BACKGROUND",    (0,4), (-1,4), WHITE),
    ("BACKGROUND",    (0,5), (-1,5), LIGHT_TEAL),
    ("BACKGROUND",    (0,6), (-1,6), WHITE),
    ("BACKGROUND",    (0,7), (-1,7), LIGHT_TEAL),
    ("BACKGROUND",    (0,8), (-1,8), WHITE),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#AAAAAA")),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [LIGHT_TEAL, WHITE]),
    ("ALIGN",         (0,0), (-1,-1), "LEFT"),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
]))
elements.append(diff_table)
elements.append(Spacer(1, 8))

# ── 2. UNCOMPLICATED CYSTITIS (First-Line) ───────────────────────────────────
elements.append(section_header("2.  UNCOMPLICATED CYSTITIS — First-Line Antibiotics", TEAL))
elements.append(Spacer(1, 3))

unc_headers = [
    Paragraph("Drug", cell_hdr),
    Paragraph("Dose", cell_hdr),
    Paragraph("Frequency", cell_hdr),
    Paragraph("Duration", cell_hdr),
    Paragraph("Notes", cell_hdr),
]
unc_rows = [
    ["Nitrofurantoin\n(Macrobid / Macrocrystals)", "100 mg", "BD (twice daily)", "7 days",
     "Preferred 1st-line. Avoid if CrCl <30 or pyelonephritis suspected."],
    ["Trimethoprim-\nSulfamethoxazole (TMP-SMX DS)", "160/800 mg", "BD", "3 days",
     "Use only if local resistance <20%. Avoid in late pregnancy."],
    ["Fosfomycin Trometamol", "3 g sachet", "Single dose", "1 day",
     "Convenient. Good in pregnancy. Not effective for pyelonephritis."],
    ["Pivmecillinam", "400 mg loading,\nthen 200 mg", "TDS", "3–7 days",
     "Low resistance; not widely available in all regions."],
]

unc_col = [usable_w*0.20, usable_w*0.15, usable_w*0.14, usable_w*0.12, usable_w*0.39]
unc_table_data = [unc_headers]
for r in unc_rows:
    unc_table_data.append([
        Paragraph(r[0], cell_bold),
        Paragraph(r[1], cell_style),
        Paragraph(r[2], cell_style),
        Paragraph(r[3], cell_style),
        Paragraph(r[4], cell_style),
    ])

unc_table = Table(unc_table_data, colWidths=unc_col)
unc_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), TEAL),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [LIGHT_TEAL, WHITE]),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#AAAAAA")),
    ("ALIGN",         (0,0), (-1,-1), "LEFT"),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
]))
elements.append(unc_table)
elements.append(Spacer(1, 8))

# ── 3. ALTERNATIVE / 2ND-LINE (Fluoroquinolones) ────────────────────────────
elements.append(section_header("3.  ALTERNATIVE / SECOND-LINE — Fluoroquinolones (use judiciously)", ORANGE))
elements.append(Spacer(1, 3))

fq_headers = [
    Paragraph("Drug", cell_hdr),
    Paragraph("Dose", cell_hdr),
    Paragraph("Frequency", cell_hdr),
    Paragraph("Duration (Cystitis)", cell_hdr),
    Paragraph("Duration (Pyelonephritis)", cell_hdr),
]
fq_rows = [
    ["Ciprofloxacin",     "250–500 mg", "BD",          "3 days",  "7–14 days IV/oral"],
    ["Levofloxacin",      "250–750 mg", "OD (once daily)","3 days","5–7 days"],
    ["Norfloxacin",       "400 mg",     "BD",           "3–5 days","Not recommended"],
    ["Ofloxacin",         "200 mg",     "BD",           "3 days",  "10–14 days"],
]
fq_col = [usable_w*0.20, usable_w*0.14, usable_w*0.16, usable_w*0.20, usable_w*0.30]
fq_table_data = [fq_headers]
for r in fq_rows:
    fq_table_data.append([
        Paragraph(r[0], cell_bold),
        Paragraph(r[1], cell_style),
        Paragraph(r[2], cell_style),
        Paragraph(r[3], cell_style),
        Paragraph(r[4], cell_style),
    ])

fq_table = Table(fq_table_data, colWidths=fq_col)
fq_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), ORANGE),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [LIGHT_ORANGE, WHITE]),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#AAAAAA")),
    ("ALIGN",         (0,0), (-1,-1), "LEFT"),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
]))
elements.append(fq_table)

fq_warn = Table([[
    Paragraph("⚠  Fluoroquinolones are NOT recommended as first-line for uncomplicated cystitis due to rising resistance and side-effect profile (tendinopathy, QT prolongation). Reserve for complicated UTI or pyelonephritis.", warn_style)
]], colWidths=[usable_w])
fq_warn.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,-1), LIGHT_RED),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 8),
    ("BOX",           (0,0), (-1,-1), 1, RED),
]))
elements.append(Spacer(1, 3))
elements.append(fq_warn)
elements.append(Spacer(1, 8))

# ── 4. SPECIAL POPULATIONS ───────────────────────────────────────────────────
elements.append(section_header("4.  SPECIAL POPULATIONS", colors.HexColor("#6C3483")))
elements.append(Spacer(1, 3))

sp_headers = [
    Paragraph("Population", cell_hdr),
    Paragraph("Preferred Drug", cell_hdr),
    Paragraph("Dose & Duration", cell_hdr),
    Paragraph("Avoid", cell_hdr),
]
sp_rows = [
    ["Pregnant women",
     "Nitrofurantoin or\nCephalosporin (e.g., Cefuroxime)",
     "Nitrofurantoin 100mg BD × 5–7d\nCefuroxime 250mg BD × 7d",
     "Fluoroquinolones, TMP-SMX in 3rd trimester, Nitrofurantoin near term"],
    ["Men (uncomplicated)",
     "TMP-SMX or Fluoroquinolone",
     "TMP-SMX 160/800mg BD × 7d\nor Ciprofloxacin 500mg BD × 7d",
     "Nitrofurantoin (poor tissue penetration in prostate)"],
    ["Elderly (>65 yrs)",
     "Nitrofurantoin or\nCephalosporin",
     "Same dose; 7 days\n(culture-guided preferred)",
     "Fluoroquinolones (CNS side effects, delirium risk)"],
    ["Recurrent UTI (≥3/yr)",
     "Based on culture/sensitivity",
     "C&S-guided; consider low-dose\nprophylaxis (Nitrofurantoin 50mg OD HS)",
     "Empiric fluoroquinolones"],
    ["Complicated UTI\n(catheter, obstruction, DM)",
     "IV Ceftriaxone 1g OD\nor IV Ciprofloxacin 400mg BD",
     "7–14 days; switch oral once afebrile",
     "Nitrofurantoin, Fosfomycin"],
]

sp_col = [usable_w*0.18, usable_w*0.24, usable_w*0.30, usable_w*0.28]
sp_bg  = colors.HexColor("#EDE7F6")
sp_hdr_color = colors.HexColor("#6C3483")

sp_table_data = [sp_headers]
for r in sp_rows:
    sp_table_data.append([
        Paragraph(r[0], cell_bold),
        Paragraph(r[1], cell_style),
        Paragraph(r[2], cell_style),
        Paragraph(r[3], cell_style),
    ])

sp_table = Table(sp_table_data, colWidths=sp_col)
sp_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), sp_hdr_color),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [sp_bg, WHITE]),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#AAAAAA")),
    ("ALIGN",         (0,0), (-1,-1), "LEFT"),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
]))
elements.append(sp_table)
elements.append(Spacer(1, 8))

# ── 5. SYMPTOM RELIEF / ADJUNCTS ─────────────────────────────────────────────
elements.append(section_header("5.  SYMPTOMATIC / ADJUNCT THERAPY", GREEN))
elements.append(Spacer(1, 3))

adj_data = [
    [Paragraph("Drug", cell_hdr), Paragraph("Dose", cell_hdr),
     Paragraph("Indication", cell_hdr), Paragraph("Notes", cell_hdr)],
    [Paragraph("Paracetamol", cell_bold), Paragraph("500–1000 mg TDS", cell_style),
     Paragraph("Fever & pain", cell_style), Paragraph("After food. Max 4g/day.", cell_style)],
    [Paragraph("Ibuprofen", cell_bold), Paragraph("400 mg TDS", cell_style),
     Paragraph("Fever, dysuria", cell_style), Paragraph("Avoid if renal impairment or GI issues.", cell_style)],
    [Paragraph("Phenazopyridine", cell_bold), Paragraph("200 mg TDS × 2 days", cell_style),
     Paragraph("Burning micturition (urinary analgesic)", cell_style),
     Paragraph("NOT an antibiotic. Turns urine orange. Max 2 days.", cell_style)],
    [Paragraph("ORS / Oral fluids", cell_bold), Paragraph("≥ 2–3 L water/day", cell_style),
     Paragraph("Hydration with fever", cell_style), Paragraph("Flushes bacteria from urinary tract.", cell_style)],
]

adj_col = [usable_w*0.22, usable_w*0.20, usable_w*0.26, usable_w*0.32]
adj_table = Table(adj_data, colWidths=adj_col)
adj_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), GREEN),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [LIGHT_GREEN, WHITE]),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#AAAAAA")),
    ("ALIGN",         (0,0), (-1,-1), "LEFT"),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
]))
elements.append(adj_table)
elements.append(Spacer(1, 8))

# ── 6. RED FLAGS ─────────────────────────────────────────────────────────────
elements.append(section_header("6.  RED FLAGS — Refer / Escalate Immediately", RED))
elements.append(Spacer(1, 3))

flags = [
    ("High-grade fever >39°C with rigors/chills",          "Consider pyelonephritis → IV antibiotics"),
    ("Loin / flank / costovertebral angle (CVA) tenderness","Upper UTI — needs parenteral therapy"),
    ("Persistent vomiting — cannot take oral meds",        "IV fluids + IV antibiotics"),
    ("Haematuria (frank blood in urine)",                  "Rule out malignancy / stones / TB"),
    ("No response to antibiotics after 48–72 hours",       "Repeat urine C&S, reassess diagnosis"),
    ("Immunocompromised / Diabetic / Transplant patient",  "Treat as complicated UTI"),
    ("Pregnancy with UTI symptoms",                        "Treat promptly, urine culture mandatory"),
]

flag_col = [usable_w*0.45, usable_w*0.55]
flag_data = []
for f in flags:
    flag_data.append([
        Paragraph("🔴  " + f[0], warn_style),
        Paragraph("➜  " + f[1], cell_style),
    ])
flag_table = Table(flag_data, colWidths=flag_col)
flag_table.setStyle(TableStyle([
    ("ROWBACKGROUNDS", (0,0), (-1,-1), [LIGHT_RED, WHITE]),
    ("GRID",           (0,0), (-1,-1), 0.4, colors.HexColor("#AAAAAA")),
    ("ALIGN",          (0,0), (-1,-1), "LEFT"),
    ("VALIGN",         (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",     (0,0), (-1,-1), 5),
    ("BOTTOMPADDING",  (0,0), (-1,-1), 5),
    ("LEFTPADDING",    (0,0), (-1,-1), 7),
]))
elements.append(flag_table)
elements.append(Spacer(1, 8))

# ── 7. INVESTIGATIONS ────────────────────────────────────────────────────────
elements.append(section_header("7.  INVESTIGATIONS", colors.HexColor("#1A5276")))
elements.append(Spacer(1, 3))

inv_data = [
    [Paragraph("Investigation", cell_hdr), Paragraph("When to Order", cell_hdr),
     Paragraph("Key Finding", cell_hdr)],
    [Paragraph("Urine Routine & Microscopy (R/M)", cell_bold),
     Paragraph("All suspected UTI cases", cell_style),
     Paragraph("Pyuria (>10 WBC/hpf), nitrites, bacteria", cell_style)],
    [Paragraph("Urine Culture & Sensitivity (C/S)", cell_bold),
     Paragraph("Recurrent UTI, failure to respond, complicated UTI, pregnancy", cell_style),
     Paragraph("Identifies organism + guides antibiotic choice", cell_style)],
    [Paragraph("CBC + CRP", cell_bold),
     Paragraph("If fever present or pyelonephritis suspected", cell_style),
     Paragraph("Elevated WBC & CRP → upper UTI / sepsis", cell_style)],
    [Paragraph("Serum Creatinine / eGFR", cell_bold),
     Paragraph("Before prescribing Nitrofurantoin or aminoglycosides", cell_style),
     Paragraph("Contraindicated if CrCl <30 mL/min", cell_style)],
    [Paragraph("Ultrasound KUB", cell_bold),
     Paragraph("Recurrent UTI, haematuria, suspected stones/abscess", cell_style),
     Paragraph("Rules out obstruction, stones, renal abscess", cell_style)],
]

inv_col = [usable_w*0.28, usable_w*0.38, usable_w*0.34]
inv_table = Table(inv_data, colWidths=inv_col)
inv_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), colors.HexColor("#1A5276")),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [LIGHT_BLUE, WHITE]),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#AAAAAA")),
    ("ALIGN",         (0,0), (-1,-1), "LEFT"),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
]))
elements.append(inv_table)
elements.append(Spacer(1, 8))

# ── FOOTER ───────────────────────────────────────────────────────────────────
footer_note = Table([[
    Paragraph(
        "📌  DISCLAIMER: This quick reference is for educational purposes only. Always adjust antibiotic choice based on local antibiogram / resistance patterns. "
        "Culture-guided therapy is preferred for recurrent or complicated UTI. This card does NOT replace clinical judgment.  "
        "Sources: IDSA/ESCMID 2010 guidelines | Textbook of Family Medicine 9e | Goldman-Cecil Medicine | Schwartz's Principles of Surgery.",
        note_style
    )
]], colWidths=[usable_w])
footer_note.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,-1), YELLOW_BG),
    ("TOPPADDING",    (0,0), (-1,-1), 6),
    ("BOTTOMPADDING", (0,0), (-1,-1), 6),
    ("LEFTPADDING",   (0,0), (-1,-1), 8),
    ("BOX",           (0,0), (-1,-1), 0.8, ORANGE),
]))
elements.append(footer_note)

# ── BUILD ────────────────────────────────────────────────────────────────────
doc.build(elements)
print(f"PDF saved: {OUTPUT}")

Running Command

cd /home/daytona/workspace/uti-pdf && python generate_uti_pdf.py

Your quick reference PDF is ready. Here's what's inside:

UTI Antibiotic Quick Reference

PDF Document · PDF

The PDF covers 7 color-coded sections on a single A4 page:

Section	Content
1. Clinical Differentiation	Cystitis vs Pyelonephritis - signs, labs, treatment route
2. First-Line Antibiotics	Nitrofurantoin, TMP-SMX, Fosfomycin, Pivmecillinam with doses & durations
3. Fluoroquinolones	Ciprofloxacin, Levofloxacin, Norfloxacin, Ofloxacin - cystitis vs pyelonephritis durations + resistance warning
4. Special Populations	Pregnant, elderly, men, recurrent UTI, complicated UTI
5. Adjunct Therapy	Paracetamol, Phenazopyridine, ORS - doses & notes
6. Red Flags	7 escalation triggers (pyelonephritis, haematuria, sepsis, etc.)
7. Investigations	Urine R/M, C&S, CBC, creatinine, USG KUB - when and why

Sources: IDSA/ESCMID guidelines, Textbook of Family Medicine 9e, Goldman-Cecil Medicine.

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