Infection: UTI

Question 1

Uncomplicated lower urinary-tract infections often respond to trimethoprim or nitrofurantoin, or alternatively, what? (3)

Answer 1

Uncomplicated lower urinary-tract infections often respond to trimethoprim or nitrofurantoin, or alternatively, 1. amoxicillin, 2. ampicillin or 3. oral cephalosporin.

Question 2

Uncomplicated UTI suggested duration of treatment

Answer 2

7 days but 3 days is usually adequate for uncomplicated urinary-tract infections in women.

Question 3

Long-term low dose therapy may be required in selected patients to prevent recurrence of UTI; indications include frequent relapses and significant kidney damage. What agents have been recommended for long-term therapy? (3)

Answer 3

1. Trimethoprim
2. Nitrofurantoin
3. Cefalexin

Question 4

Why should methenamine hippurate (Hiprex) not generally be used for UTI?

Answer 4

It requires an acidic urine for its antimicrobial activity and it is ineffective for upper urinary-tract infections; it may, however, have a role in the prophylaxis and treatment of chronic or recurrent uncomplicated lower urinary-tract infections.

Question 5

Acute pyelonephritis can lead to what?

Answer 5

Septicaemia; treated initially by injection of a broad-spectrum antibacterial such as a cephalosporin (e.g. cefuroxime) or a quinolone if the patient is severely ill; gentamicin can also be used.

Question 6

Acute pyelonephritis can lead to septicaemia and is treated initially by injection of a broad-spectrum antibacterial such as what?

Answer 6

Acute pyelonephritis can lead to septicaemia and is treated initially by injection of a broad-spectrum antibacterial such as a cephalosporin (e.g. cefuroxime) or a quinolone if the patient is severely ill; gentamicin can also be used.

Question 7

What aminoglycoside can be used for upper UTI?

Answer 7

Acute pyelonephritis can lead to septicaemia and is treated initially by injection of a broad-spectrum antibacterial such as a cephalosporin (e.g. cefuroxime) or a quinolone if the patient is severely ill; gentamicin can also be used.

Question 8

What is the suggested duration of treatment for upper UTIs?

Answer 8

Suggested duration of treatment is 10–14 days (longer treatment may be necessary in complicated pyelonephritis).

Question 9

Prostatitis can be difficult to cure and requires treatment for several weeks with an antibacterial which penetrates prostatic tissue such as what?

Answer 9

Some of the quinolones (ciproflox or ofloxacin), or alternatively, trimethoprim: 28 days.

Question 10

Suggested duration of treatment for prostatisis is what? Using what?

Answer 10

Prostatitis can be difficult to cure and requires treatment for several weeks with an antibacterial which penetrates prostatic tissue such as some of the quinolones (ciprofloxacin or ofloxacin), or alternatively, trimethoprim.

Suggested duration of treatment is 28 days.

Question 11

What are the most suitable antibiotics for UTI in pregnancy?

Answer 11

Penicillins and cephalosporins are suitable for treating urinary-tract infection during pregnancy. Nitrofurantoin may also be used but it should be avoided at term. Sulfonamides and quinolones should be avoided during pregnancy; trimethoprim should also preferably be avoided particularly in the first trimester.

Question 12

Nitrofurantoin can be used in UTI in pregnancy, but should be avoided when?

Answer 12

Near term.

Question 13

Trimethoprim can be used for UTI in pregnancy but should be avoided when?

Answer 13

In the first trimester.