Infectious Diseases II: UTI Flashcards
Common symptoms of cystitis
Dysuria urgency, frequency burning nocturia hematuria (blood in urine)
Symptoms of pyelonephritis
Flank pain
abdominal pain
fever
n/v
“Positive” urinalysis
pyuria
+ leukocyte esterase or WBC > 10
bacteruria
Common pathogens for uncomplicated cystitis
E. coli (most common)
Proteus
Klebsiella
enterococcus
preferred antibiotics for uncomplicated cystitis
Nitrofurantoin 100 mg BID x 5 days
Bactrim DS BID x 3 days (avoid in areas with high resistance rates of E. coli)
Fosfomycin 3 g x 1 dose
Alternative treatment for uncomplicated cystitis
cipro 250 mg BID x 3 days
Levofloxacin 250mg daily x 3
Beta lactam (Augmentin, oral cephalosporin) x 3-7 days
Preferred outpatient treatment for uncomplicated pyelonephritis
Cipro 500 mg BID x 7
Levofloxacin 750 mg x 5
Consider 1 dose of ceftriaxone if FQ resistance is high
Bactrim DS x 14 days
Amox/clav, cefdinir, cefaclor, cefpodoxime x 10-14 days
Inpatient treatment for uncomplicated pyelonephritis
Ceftriaxone
Ampicillin + gent
cipro or levofloxacin
ZOsyn
treat for total of 14 days
Complicated UTIs are treated differently than pyelonephritis (t/f)
False use same drugs as uncomplicated pyelo ESBL +: use carbapenem Treat for 7 days if prompt response 10-14 days if delayed response
When is UTI prophlyaxis appropriate?
3+ epsiodes in 1 year
Agents used for UTI prophylaxis
Bactrim ss daily
Nitrofurantoin 50 mg daily
Bactrim DS taken after sex
Asymtomatic bacteruria must be treated in all pregnant women (t/f)
TRUE
if untreated can lead to premature birth
usually beta lactam is used for 3-7 days
Nitrofurantoin and Bactrim can be used if severe b-lactam allergy is present
Urinary analgesic used for UTI’s
Phenazopyridine (pyridium, Azo)
Dose of phenazopyridine
200 mg TID x max of 2 days
take with or right after meal
causes stomach upset, HA, dizziness, change urine and other body fluids orange-reddish