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Therapeutics P3 Spring > pediatric UTI > Flashcards

pediatric UTI Flashcards

1
Q

Risk factors for development of UTIs in children

A
  • female
  • uncircumcised male
  • younger age groups (neonates/infants)
  • constipation
  • anatomic abnormalities (vesicoureteral reflux - VUR)
  • functional abnormalities
  • female sexual activity
  • immunocompromised
  • diabetes
  • genetic predisposition
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2
Q

Most common causative pathogen

A

E. Coli

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3
Q

4 infection pathways

A

1.) Retrograde ascent (most common)
2.) Nosocomial infection
3.) Hematogenous route
4.) Fistula (rare)

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4
Q

Retrograde ascent

A

bacteria enter through urethra and migrate to bladder

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5
Q

Nosocomial infection

A

bacteria introduced via foreign body (catheter) to the urinary tract
- generally more resistant pathogens

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6
Q

Hematogenous route

A

systemic infection with subsequent UT seeding
- more common in infants and immunosuppressed patients

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7
Q

Fistula

A

between UT and GI/vagina
- rare

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8
Q

Cystitis

A

Lower UTI
infection site: bladder

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9
Q

Urethritis

A

Lower UTI
infection site: urethra

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10
Q

Pyelonephritis

A

Upper UTI
infection site: kidney

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11
Q

Complicated vs Uncomplicated UTI

A

Complicated: structural/functional abnormalities or catheters

Uncomplicated: none of the above

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12
Q

Signs and symptoms of UTI in neonates

A
  • jaundice
  • failure to thrive
  • fever
  • difficulty feeding
  • irritability
  • vomiting and diarrhea
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13
Q

Signs and symptoms of UTI in infants and children < 2 years old

A

-failure to thrive
- fever
- difficulty feeding
- irritability
- vomiting and diarrhea
- cloudy or malodorous urine
- hematuria
- dysuria

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14
Q

Signs and symptoms of UTI in children > 2 years old

A
  • fever
  • frequency
  • dysuria
  • enuresis
  • hematuria
  • abdominal pain
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15
Q

UTI definition

A

Significant bacturia + pyuria
- clean catch: > 100,000 cfu/ mL of 1 bacteria
- catheterization: > 50,000 cfu/mL of 1 bacteria
- suprapubic aspiration: any growth of bacteria

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16
Q

First line UTI treatments

A
  • cephalosporins
  • TMP/SMX
  • b lactam/ b lactamase inhibitor
17
Q

parenteral administration in patients:

A
  • septic
  • < 2months old
  • immunocompromised
  • unable to tolerate PO
18
Q

Duration of therapy

A

Uncomplicated UTI = 7 days
Pyelonephritis = 10-14 days

19
Q

Ampicillin dosing

A

IV: 100-200 mg/kg/day divided Q 4-6H

20
Q

Cefazolin (1st gen) dosing

A

IV: 50 mg/kg/d divided Q6-8H

21
Q

Cefotaxime (3rd Gen) dosing

A

IV: 100-150 mg/kg/d divided Q6-8H

22
Q

Ceftriaxone (3rd gen) dosing

A

IV: 50-75 mg/kg/d divided Q12-24H
- avoid in neonates: biliary sludging

23
Q

Ceftazidime (3rd gen) dosing

A

IV: 100-150 mg/kg/d divided Q8H

24
Q

Cefepime (4th gen) dosing

A

IV: 100 mg/kg/d divided Q12H

25
Q

Ciprofloxacin dosing

A

IV: 18-30 mg/kg/d divided Q8H
-ADE: tendon rupture, tendonitis

PO: 20-40 mg/kg/d divided Q12H

26
Q

Gentamicin dosing

A

IV: 5-7.5 mg/kg/d divided Q8-24H
- nephrotoxicity / ototoxicity

27
Q

Tobramycin dosing

A

IV: 5-7.5 mg/kg/d divided Q8-24H
- nephrotoxicity / ototoxicity

28
Q

Amox/Clav dosing

A

PO: 40-50 mg/kg/d divided Q8-12H

29
Q

Cephalexin (1st gen) dosing

A

PO: 50 mg/kg/d divided Q6H

30
Q

Cefixime (3rd gen) dosing

A

PO:
- 8 mg/kg/dose Q12H x 1 day
- 8 mg/kg once daily

31
Q

Cefpodoxime (3rd gen) dosing

A

PO: 10 mg/kg/d divided Q12H

32
Q

Ceftibuten (3rd gen) dosing

A

PO:
- 9 mg/kg/dose Q12H x 1 day
- 9 mg/kg once daily
- serum sickness rxn

33
Q

Nitrofurantoin dosing

A

PO: 5-7 mg/kg/d divided Q6H
- urine discoloration

34
Q

TMP/SMX dosing (based on TMP)

A

PO: 8-12 mg/kg/d divided Q12H
- hematologic AE
- interstitial nephritis
- avoid in infants < 2 months

35
Q

Vesicoureteral Reflux (VUR)

A

retrograde urinary flow from bladder into ureters and possibly renal collecting system and renal pelvis
- grades I-V

36
Q

Target populations for UTI prophylaxis

A
  • females
  • VUR grade IV or V
  • bladder/bowel dysfunction
37
Q

UTI prophylaxis in neonates/ infants 2 months old or younger:

A

Amoxicillin
- 10-15 mg/kg once daily

38
Q

UTI prophylaxis in infants > 2 months

A

Nitrofurantoin
- 1-2 mg/kg once daily

TMP/SMX
- 2 mg/kg once daily
- 5 mg/kg twice weekly

Therapeutics P3 Spring (32 decks)

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