UTI

Question 1

uncomplicated UTI

Answer 1

child-bearing age

Question 2

complicated UTI

Answer 2

structure/function abnormalities, male, elderly

Question 3

bacteria associated w/ most UTI

Answer 3

E. Coli
less common= Klebsiella pneumoniae, proteus, satph saprophyticus, enterococcus

Question 4

bacteria causing complicated UTI

Answer 4

resistant organisms enterobacter and pseudomonas aeruginosa

Question 5

three primary empiric tx options uncomplicated UTI

Answer 5

fosfomycin x1 (less effective)
SXT x3 (increasing resistance; use if resistance rate < 20%)
nitrofurantoin x5

Question 6

option for uncomplicated UTI if 3 primary can’t be used

Answer 6

3 day fluoroquinolones (high risk collateral damage) or 3-7 day beta lactams (less efficacy & higher SE)

*Ampicillin & amoxicillin NOT considered

Question 7

What does nitrofurantoin on BEERS list mean

Answer 7

avoid if CrCl < 60; can be effective in CrCl as low as 30

Question 8

tx acute pyelonephritis

Answer 8

1 fluoroquinolone x5-7 days with 1x dose cipro or ceftriaxone IV x1 if area with resistance

Other tx:
SXT or beta lactam all with 1x IV dose ceftriaxone or aminoglucoside (gentamicin)

Question 9

tx UTI during pregnancy

Answer 9

1 beta lactams

#2 nitrofurantoin (except in last 30 days)
fosfomycin appears safe but little research

f/u culture 1-2 weeks after complete tx then monthly

Question 10

prostatitis tx

Answer 10

1 fluoroquinolones & SXT

#2 cephalosporins or PCNs

x2 weeks!!!