Urinary tract infections

Question 1

urinary tract infection

Answer 1

infection anywhere in the urinary tract

E.coli is the most common bacteria
klebsiella
proteus
pseudomonas

increasing antimicrobial resistance

uncomplicated:
infection in otherwise healthy female

complicated:
male
comorbid conditions
failure to respond to therapy

urine dip stick
leukocyte esterase
nitrites

urine cultures are not indicated for uncomplicated UTI
mid stream collection

Question 2

Asymptomatic bacteriuria

Answer 2

women with a positive culture but no symptoms do not require treatment unless pregnant or requiring clearance before an invasive urologic procedure

Question 3

cystitis

Answer 3

non pregnant women:
trimethoprim  3 days
cephalexin  5 days
nitrofurantoin  5 days
amoxycillin + clavulonic acid 5 days

pregnant women:
cephalexin 5 days
nitrofurantoin 5 days
amoxycillin + clavulonic acid 5 days

Men:
trimethoprim  7 days
cephalexin  7 days
nitrofurantoin  7  days
amoxycillin + clavulonic acid 7 days

Question 4

pyelonephritis

Answer 4

fever
back pain
loin to groin pain
nausea and vomiting

Treatment: mild
amoxycillin+clavulanate, 10 to 14 days
cephalexin 10 to 14 days
Trimethoprim 10 to 14 days

Severe infection:

gentamicin
PLUS
amoxy/ampicillin

or ceftriaxone

Question 5

Prostatitis

Answer 5

Acute prostatitis usually presents with fever, marked acute lower urinary tract symptoms (eg frequency, dysuria), perineal pain, and extreme prostatic tenderness on rectal examination

Treatment:
trimethoprim
amoxycillin+clavulanate
cephalexin

Chronic bacterial prostatitis
ciprofloxacin 500 mg orally, 12-hourly for 4 weeks