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PR3151 Revision > IC13 UTI > Flashcards

IC13 UTI Flashcards

1
Q

What are the factors determining UTI development? (3)

A
  1. Host defence mechanisms
  2. Size of inoculum
  3. Virulence / Pathogenicity (E. coli with pilli hard to washout)
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2
Q

What are host defence mechanisms in UTI? (4)

A
  1. Diuresis in bacteria presence
  2. Antibacterial properties of urine and prostatic secretions
  3. Anti-adherence mechanisms in bladder wall
  4. Inflammatory response with PMN (phacogytes)
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3
Q

What are the risk factors for UTI? (10)

A
  1. Sex
  2. Urinary tract abnormalities
  3. Neuro dysfunction
  4. Use of anti-cholinergics
  5. Catheterisation
  6. DM
  7. Pregnancy
  8. Spermicidal or diaphragm use
  9. UTI history
  10. Female
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4
Q

What are the counselling points for UTI? (7)

A
  1. Drink more water (6-8 cups)
  2. Pee upon urge
  3. Pee after sex
  4. Wear cotton underwear and loose fitting clothes
  5. Wipe front to back
  6. Try other methods of contraceptives
  7. Try not to use unlubricated condoms as they can irritate
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5
Q

What are the two testing methods for UTI?

A

UFEME and dipstick test

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6
Q

What does UFEME assess?

A

Pyuria, hematuria and UUTI (from casts)

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7
Q

What does the dipstick test assess?

A

Nitrite and Leukocyte esterase

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8
Q

What does nitrite positive mean?

A

Gram negative bacteria

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9
Q

What does LE positive mean?

A

Leukocytes present in urine, pyuria

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10
Q

When should you culture urine? (5)

A

Pregnant women
Recurrent UTI
Pyelonephritis
Catheter-associated UTI
UTI in men

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11
Q

Main pathogen for uncomplicated or CA-UTI?

A

85% E. coli

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12
Q

Pathogens for complicated or HA-UTI?

A

E. coli, GN bacilli and Pseudomonas

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13
Q

What are the HA-UTI risk factors? (4)

A
  1. Past hospitalisation in the last 90 days
  2. Current hospitalisation 2 or more days
  3. Residence in nursing home
  4. Current abx use
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14
Q

When to treat UTI? (3)

A
  1. Pregnant women
  2. Urologic procedure where mucosal damage is expected
  3. Symptomatic UTI
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15
Q

Treatment for Cystitis in Women
(first line)

A

PO Co-trimoxazole 800/160mg BD x 3 days
PO Nitrofurantoin 50mg QDS x 5 days

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16
Q

Treatment for Cystitis in Women
(alternatives) (4)

A

PO Cephalexin 250-500mg QDS x 10-14 days
PO Cefuroxime 250mg BD x 10-14 days
PO Amoxicillin-clavulanate 625mg BD x 10-14 days
PO Fosfomycin 3g single dose

17
Q

Treatment for Pyelonephritis in Women (first line) (2)

A

PO Ciprofloxacin 500mg BD x 7 days
PO Levofloxacin 750mg BD x 5 days

[Pyelo = FQ]

18
Q

Treatment for non-severe Pyelonephritis in Women (alternatives) (4)

A

PO Co-trimoxazole 800/160mg BD x 10-14 days
PO Cephalexin 500mg QDS x 10-14 days
PO Cefuroxime 500mg BD x 10-14 days
PO Amoxicillin-clavulanate 625mg BD / 1g TDS x 10-14 days

19
Q

Treatment for severe Pyelonephritis in Women (2) (hint: severe so IV)

A

IV Cefazolin 1g q8h
IV Amoxicillin-clavulanate 1.2g q8h

20
Q

Treatment for severe Pyelonephritis in Women (alternatives) (2) (hint: IV beta-lactams)

A

IV Cefazolin 1g q8h
IV Amoxicillin-clavulanate 1.2g q8h

21
Q

Concern for prostatitis in men?

A

(add) PO Ciprofloxacin 500mg BD x 10-14 days

22
Q

Treatment for Nosocomial infections (first line) (hint: IV)

A

IV Cefepime 2g q12h (with)
IV Amikacin 15mg/kg q24h x 7-14 days

[NOSO = CARBA]
[Carbapenem + AG]

23
Q

Treatment of mild nosocomial UTI? (2)

A

PO Ciprofloxacin 500mg BD x 7-14 days
PO Levofloxacin 750mg BD x 7-14 days

24
Q

Treatment of catheter-associated UTI (first line) (hint: IV)

A

IV Cefepime 2g q12h (with)
IV Amikacin 15mg/kg single dose x 7-14 days

[NOSO = CARBA]
[Carbapenem + AG]

25
Q

Treatment of catheter-associated UTI or nosocomial UTI? (alternative treatment)

A

IV Imipenem 500mg q6h x 7-14 days
IV Meropenem 1g q8h x 7-14 days

[cath alternatives (CA) = carbapenems]

26
Q

Drugs to avoid in pregnancy?

A

Ciprofloxacin
Co-trimoxazole (1, 3 trimester)
Nitrofurantoin (at term 38-42 wks)
Aminoglycosides

27
Q

Duration of treatment for pyelonephritis in women?

A

10-14 days

28
Q

Duration of treatment for nosocomial UTI?

A

7-14 days

29
Q

Duration of treatment for cath-associated UTI

A

7 days, extend to 10-14 in delayed response

PR3151 Revision (7 decks)

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