UTI

Question 1

what is the typical causative organism of a UTI

Answer 1

E.coli (90%)

can also be:

• proteus
• kelbsiella
• enterococcus

Question 2

how does a lower UTI present

Answer 2

Dysuria
Suprapubic pain 
Urgency and frequency
confusion in older patients 
haematuria (microscopic?)
cloudy/ foul smelling urine

Question 3

how does an upper UTI present

Answer 3

less urinary problems

fever
malaise
loin/flank pain
vomiting
haematuria

Question 4

how do you investigate a UTI

Answer 4

Urine dipstick for:

• nitrites (E.coli breaks down nitrates into nitrites)
• leukocytes (raised= infection)
• blood (often microscopic)

renal ultrasound for e.g. hydronephrosis

Question 5

how do you manage an upper UTI

Answer 5

broad spectrum antibiotics

e. g.
- cephalosporin
- aquinolone
- gentamycin

Question 6

how do you manage a lower UTI

Answer 6

oral trimethoprim or nitrofurantoin

3 days for a simple UTI

5-10 days for immunosuppressed or abnormal anatomy/ kidney function

7 days for men, pregnant women or catheter related

Question 7

how long should you give antibiotics for lower UTIs in different people

Answer 7

3 days for a simple UTI

5-10 days for immunosuppressed or abnormal anatomy/ kidney function

7 days for men, pregnant women or catheter related

Question 8

which antibiotic should you avoid in pregnant women with a lower UTI

Answer 8

Nitrofurantoin unless in the second trimester