UTI

Question 1

What is a UTI?

Answer 1

infections that can affect any part of the urinary tract

More common in women

Question 2

Whats the most common causative organism of utis?

Answer 2

Escherichia coli

Question 3

What cause is more in people who are immunocompromised or have an indwelling catheter?

Answer 3

Candida albicans

Question 4

Where is affected in a lower UTI?

Answer 4

bladder (cystitis) and urethra (urethritis)

Question 5

Where is affected in an upper UTI?

Answer 5

proximal part of the ureters (pyelitis)
proximal part of the ureters
the kidneys (pyelonephritis)

Question 6

What are some complications of upper uti?

Answer 6

renal scarring, abscess or failure, and sepsis

Question 7

What are common signs and symptoms of Lower UTI?

Answer 7

-dysuria
-increased urinary frequency and urgency
-urine that is strong smelling, cloudy or contains blood
-persistent lower abdominal pain

Question 8

What are common signs of upper uti?

Answer 8

Loin pain
Fever

Question 9

What non-drug treatment should be advised in uti?

Answer 9

Lots of fluids
Wiping front to back
Not delaying urination

Question 10

What is first line abx for uti?

Answer 10

Oral Trimethoprim or Nitrofurantoin

Question 11

What is second line abx for uti in non pregnancy women?

Answer 11

Nitrofurantoin (if not used first line), fosfomycin, pivmecillinam hydrochloride, or amoxicillin

Question 12

Whats the first choice abx for men with UTI?

Answer 12

Nitrofurantoin, or trimethoprim

If no improvement consider pyelonephritis or prostatitis

Question 13

What are the abx choices for pregnant women with UTI?

Answer 13

Oral first line: Nitrofurantoin.

Oral second line (if no improvement after at least 48 hours, or first line not suitable):
Amoxicillin (only if culture susceptible), or cefalexin.

Question 14

What investigations can be done for suspected UTI?

Answer 14

Urine dipstick
Mid stream urine sample sent off for culture and susceptibility testing

Question 15

What can be given for recurrent UTIs?

Answer 15

Prophylactic abx - low dose
The abx is changed every few months
Trimethoprim, nitrofurantoin or amoxicillin

Question 16

What abx are used for catheter associated UTI?

Answer 16

-Oral first line (if no upper UTI symptoms):
Amoxicillin (only if culture susceptible), nitrofurantoin, or trimethoprim (if low risk of resistance).

-Oral second line (if no upper UTI symptoms and first-line not suitable):
Pivmecillinam hydrochloride.

-Oral first line (upper UTI symptoms):
Cefalexin, ciprofloxacin, co-amoxiclav (if culture susceptible), or trimethoprim (if culture susceptible).

-Intravenous first line (if severely unwell or unable to take oral treatment). Antibacterials may be combined if concerned about susceptibility or sepsis.
Amikacin, ceftriaxone, cefuroxime, ciprofloxacin, gentamicin, or co-amoxiclav (only in combination, unless culture results confirm susceptibility).