Info

Question 1

What is meant by “Uncomplicated UTI”

Answer 1

Healthy, premenopausal women w no HD of UT abnormalities (no stones, obstruction, urethral strictures, vesicouretal reflux) GU instrumentation)

• Not DM
• Not immunocompromiesed

Question 2

Culture

Answer 2

Only for

1. men
2. pregnant
3. pyelonephritis
4. recurrent (within 2weeks or frequent)
5. CA UTI

Question 3

Risk factor of UTI

Answer 3

Female
Sexual intercourse, diaphragm, spermicides
Genetic association
Catheter
DM
Pregnant
Abnormalities of UTI (stones, urethras strictures, prostatic hypertrophy, vesicouretal reflux)
Anticholinergic
Previous UTI 

Catheter, DM, Pregnant lady has a abnormal UTI, with stones, with prostatic hypertrophy and takes anticholoinergic OMG and has previous UTI OMG

Question 4

ASB

Answer 4

For pregnant to reduce risk for pyelo , Low birth weight and preterm labour

for invasive urologic procedures before TURP, cryptoscopy w biopsy . After culture is out, start prophylaxis 12-24hr before procedure, to prevent post operative sepsis, bacteremia

Question 5

When can i treat CA-UTI

Answer 5

Only when it is symptomatic
Sx:
Onset, worsening of fever, rigors, altered mental status , malaise or lathargy

Flank pain, costovertebral angle tenderness
Acute hematuria
Pevic discomfort

Question 6

What should i do other than giving ABX for CA-UTI

Answer 6

1. Avoid unnecessary catheter.
   - If still indicated, change catheter if it has been there for >2wks
   - use minimal duration (try trial off)
   - change before block
2. Use closed system
3. Ensure aseptic insertion
4. Dont use topical abx, antiseptic, prophylactic abx, antiseptic, chronic suppressive abx

Question 7

Treatment length

Answer 7

Uncomplicated: specified

Complicated: longer

Pyelo: specified
Nosocomial pyelo: 7-14days (IV)

Men: 10-14days, 6 weeks

CA-UTI: 7, 10-14 (IV)

Pregnant: 7 (ASB or actual UTI) or 14 (pyelo)

Question 8

non-pharmacoogical advice to prevent UTI

Answer 8

1. drink enough water
2. bathroom habits:
   a. dont hold pee
   b. after urinating or have bowel movement, wipe from front to back
   c. avoid douching
3. urinate shortly after sex
4. switch birth control from diaphragm/unlubricated condom w spermicide to OCP/ change to lubricated w/o spermicide or unspermicidal condom
   (X unlubricated)
   (X spermicides)
5. wear loose fitting clothes and cotton underwear to keep area around urethra dry
6. Cranberry juice (inhibit adherence of E.coli), intraV- E cream, lactobacillus probiotics to restore vaginal flora and prevent colonisation with E.coli

Question 9

Repeat culture

Answer 9

When pt dont respond

For pregnant women to document they clear from infection

Question 10

UTI drug mgt other than abx for fever/vomitting/pain in urinary tract

Answer 10

Alkaniser (Na Citrate) - relief discomfort in mild UTI

Phenazopyridine (Urogesic). 
100-200mg TDS 
A dye for analgesic proferties on UT mucosa, only pain then use!
- NOT FOR G6PD
- SE: urine & feces red-orange , N/V