Urinary Tract Infection (UTI) Flashcards
What are the causes of UTIs?
Proximity to anus
E. Coli
Pregnancy
Catheters
Kidney stones
Enlarged prostate
Constipation (kids)
Familial link
Urinary tract abnormality
Weakened immune system
Why may enlarged prostate cause UTI?
Blockage of urinary flow = bacteria stuck
Why may constipation cause UTI?
Faecal loading puts pressure on bladder = urinary flow impaired
What are symptoms of infection?
Increased urgency
Increased frequency
Cloudy urine
Dysuria
New nocturia
Systemically unwell = fever
Suprapubic pain
How do you do a test?
Dipstick
OR mid stream culture
What does it mean if leucocytes are present?
Bacteria
What does it mean if nitrites are present?
Bacteria
What does it mean if bilirubin is present?
Liver disease
What does it mean if proteins are present?
Damage to glomerulus
What does it mean if blood is present?
Infection
Tumour
Trauma
What does it mean if glucose is present?
Diabetes
What can be used as self-care?
Water
Paracetamol
Ibuprofen
What is the 1st line empirical antibiotic?
Nitrofurantoin 100mg BD 3 days
OR
Trimethoprim 200mg BD 3 days
What is different for men for 1st line treatment?
Take for 7 days
= indicates something
When must you come back after treatment?
Symptoms
Shivering, chills + muscle pain
Confused
Smelly urine
N+V
Visible blood
Temperature above 38 OR below 36
Kidney pain in back
Symptoms worsen
Symptoms don’t improve after 48hrs
How do you prevent UTIs?
Wipe from front to back
Don’t wait to pass urine
Urinate after sex
Drink enough fluids
Avoid occlusive underwear
What happens with recurrent UTIs?
(2 episodes over 6 months or >3 infections/year)
Patient initiated self-treatment
Post-coital prophylaxis
Continuous prophylaxis
What happens in patient initiated self-treatment ?
Give antibiotics in advance
= have symptoms = take
What happens in post-coital prophylaxis ?
Antibiotics/weeing after sex
What happens in continuous prophylaxis?
Long term antibiotics
BUT antibiotic resistance
What is the first choice for prophylaxis?
Trimethoprim
OR Nitrofurantoin
What is the 2nd choice for prophylaxis?
Amoxicillin
OR Cefalexin
What are the treatment group considerations?
Pregnant
Male
Obese
Elderly
Children
What happens in pregnancy if present of bacteria but no symptoms?
Still treat
What is 1st line for UTI in pregnancy?
Nitrofurantoin 100mg BD for 7 days
What is the 2nd line for pregnancy UTI?
Amoxicillin 500mg TDS 7 days
OR Cefalexin 500mg BD 7 days
What do you do with people with catheters?
Check for blockages
Remove or change
Need 7 day course
What is the treatment of acute pyelonephritis or upper UTI children older than 3 months?
Cefalexin
OR Co-amoxiclav
What is the treatment of lower UTI in children older than 3 month?
Trimethoprim
OR Nitrofurantoin, Amoxicillin or Cefalexin
What are indicators of severe illness from UTI in children?
Temperature
RR
HR
Capillary refill time
Effort breathing
Colour of skin, lips + tongue
Appearance of mucous membranes
