Lower UTI

Question 1

Presentation of lower UTI?

Answer 1

• Dysuria
• Urinary frequency
• Urinary urgency
• Cloudy/offensive smelling urine
• lower abdo pain
• fever
• malaise
• confusion in elderly patients

Question 2

What investigations to do in suspected lower UTI?

Answer 2

• Treat if clinical picture present
• Can do urine dip
• Urine MCS done only if 1st treatment didn’t work

Question 3

What are the causative organisms of lower UTI?

Answer 3

• E. coli (80%)
• Pseudomonas
• Proteus

Question 4

What are some pre-disposing factors to lower UTI?

Answer 4

• Infrequent voiding
• obstruction by full rectum/constipation
• developmental anomaly
• poor hygiene

Question 5

What is the management of non-pregnant women for lower UTI?

Answer 5

*Trimethoprim or nitrofurantoin for 3 days

Question 6

When should a urine culture be sent for lower UTI first presentation?

Answer 6

• >
  65. years
• visible or non-visible haematuria
• pregnant women

Question 7

What is the management of pregnant symptomatic women with lower UTI?

Answer 7

*Urine culture sent
*First line: nitrofuratoin but avoid in 3rd trimester
*2nd line: amoxicillin or cefalexin
(7 day course)

Question 8

What is the management of pregnant asymptomatic women with lower UTI?

Answer 8

*Urine culture sent
*7 day course of abx:
>1st line Nitrofuratoin (Avoided in 3rd trimester)
>2nd line: amoxicillin/cefalexin
(treated as risk of progression to acute pyelonephritis)

Question 9

What is the management of men with lower UTI?

Answer 9

*immediate antibiotics offered

Question 10

What is done in catheterised patient with asymptomatic bacteria?

Answer 10

*not treated, only treated if symptomatic