Urinary Tract infections Flashcards
What are the host factors in UTIs?
repeated UTIs that alter bladder endothelium, girls have shorter urethras, incomplete bladder emptying, pregnancy
What are behavioral factors that affect UTIs?
STIs and resisting urge to void
What are microbial factors with UTI
E coli attaching to bladder mucosa
What are the antibiotics used to treat UTIs?
bactrim, nitrofuratoin, fluoroquinolones, cephalosporins, and PCNS
Does cranberry juice help with UTIs?
decreases incidence of symptomatic UTIs
What is a pain med for UTIs?
phenazopyridine
What are the goals of treatment in a UTI?
Erradicate causitive organism, relieve symptoms, prevent recurrence
What is the rational drug selection for UTI drug therapy?
needs gram negative coverage; first choice is bactrim, i if allergic to sulfa, other choice is cipro. Second line choice is cephalosporin. Nitrofurantoin is also option
What is the length of treatment for UTI?
Generally 3 days; 10 days in children or others with diabetes, immunosuppressed, really symptomatic etc.
What are the resistance patterns present with UTI?
E coli resistance to bactrim is 15 to 20 percent;
same level of resistance is reported for cipro and levofloxacin;
amoxicillin not recommedned because up to one thrid of UTI organisms are resistant to it.
What are the cost considerations in UTI treatment?
Bactrim is cheapest, generic cipro also cheap
What is the rational drug selection for children with UTIs?
get specimen with catheter, treat for 10 days with something like rocephin untiil afebrile; do a follow up culture
What are UTI considerations for older adults?
risk for asymptomatic UTI
What are the UTI considerations for males?
enlarged prostate increases risk fo UTI
What are UTI considerations during pregnancy
asymptomatic bacteriuria and routine screening
what are montioring considerations for UTI?
in women if symptoms persist after 48 hours get a urine culture; in people with recurrent UTI get a urine culture and do a post treatment urinalysis; in children under 5 do a culture, a re-culture after treatment, and maybe radiological workup; in pregnany women do a workup every 2 weeks until delivery
What is the outcome evaluation for UTIs?
in children under 5, consider anatomical issues like vesicoureteral reflux; in adults consider urology referral with gross hematruia, symptoms of obstruction, persistant UTI, symptoms in pregnant woman, and fever and dehydration
What is patient education for UTIs
Take meds as directed and finish full dose of antibiotics; Lifestyle changes like drinking cranberry juice, dont use spermacides or diaphragms, void after intercourse, drink 2 L of fluid a day, don’t resist urge to void
