UTI

Question 1

symptoms of acute uncomplicated uti/cystitis

Answer 1

urine frequency
urgency
internal dysuria
no fever

Question 2

common bacterial causes of cystitis?

Answer 2

Most common: E. coli

others: Staph saprophyticus, klebsilla pneumo, p. mirabalis.
no gram positives.

Question 3

1st line antibiotics for cystitis?

Answer 3

nitrofurantoin x5
smx/tmp x3
fosfomycin x1

Question 4

2nd line abx for cystitis?

Answer 4

cipro/levo/nor-floxacon x 3 days or
cephalexin x 7 days

Question 5

symptoms of mild-mod pyelonephritis

Answer 5

fever
flank pain
n/v with or without urine symptoms

Question 6

bacterial causes of pylonephritis

Answer 6

E. coli, klebsiella, p. mirabalis

Question 7

1st line for pyelonephritis

Answer 7

cipro or levofloxacin x 7-14 days

Question 8

2nd line abx for pyelonephritis

Answer 8

amoxi-clav x 10-14 ds OR
smx/tmp x 10-14 ds OR
trimethoprim x 10-14 ds

(avoid nitrofurantoin)

Question 9

1st line for severe pyelonephritis?

Answer 9

aminoglycoside IV +/- ampicillin IV x 10-14 days

Question 10

What is considered to be complicated UTI?

Answer 10

structural/functional abnormalities
male, children, pregnancy
Diabetes, catheters, immunocompromised

Question 11

When should you treat asymptomatic bacteriuria?

Answer 11

If pt is pregnant or undergoing endourological procedures , otherwise it is left untreated

Question 12

Common pathogens in complicated UTI

Answer 12

PEK (Proteus, E. coli, Klebsiella), or Enterococcus faecalis

Question 13

Treatment for complicated UTI?

Answer 13

1. smx/tmp po x 7 days
2. amoxi/clav x 7-10 days
3. cefixime x 7-10 ds
4. FQs (cipro/levo/norflox) po x 7-14 days

Question 14

first line for uncomplicated pyelonephritis

Answer 14

cipro x 7 days, or levo x 5 days

Question 15

first line for inpatient/complicated pyelonephritis

Answer 15

1. Aminoglycoside (+ ampicillin if Enterococcus suspected ) x 10-14 days
2. FQs IV x 7-14 days
3. 3rd gen ceph - cefepime, or pip/tazo IV x 10-14 days
4. carbapenem IV x 7-14 days

Question 16

What is considered uncomplicated pyelo?

Answer 16

can take PO pills
mild-mod illness
manageable dehydration

Question 17

Drug choices to cover hospital acquired ESBL?

Answer 17

carbapenem (preferable: ertapenem IV)
aminoglycosides

Question 18

Drug choices to cover hospital acquired Pseudomonas?

Answer 18

pip/tazo, cefipime, meropenem, iminpnem/cilastatin, cipro/levo

Question 19

Drug choices to cover hospital acquired resistant enterococcus?

Answer 19

vancomycin IV, linezolid, daptomycin

Question 20

Drug of choice for acute bacterial prostatitis?

Answer 20

1. SMX/TMP
2. FQs
3. If STI-related: ceftriaxone then doxycycline
   DURATION: 4 WEEKS

Question 21

Drugs of choice for CHRONIC bacterial prostatitis?

Answer 21

same for acute =
1. SMX/TMP
2. FQs
3. If STI-related: ceftriaxone then doxycycline
DURATION: 4 to 6 WEEKS (longer)

Question 22

What counts as recurrent UTI?

Answer 22

2+ infections in last 6 months or 3+ in last 12 months

Question 23

1st line drug for long-term low dose prophylaxis of uti?

Answer 23

SMX/TMP

Question 24

Pregnancy and nitrofurantoin?

Answer 24

avoid NTF in 3rd trimester

Question 25

Pregnancy and SMX/TMP?

Answer 25

Avoid drug in 1st trimester (and TMP), and in the last 6 weeks of pregnancy

Question 26

Pregnancy and FQs?

Answer 26

Avoid all throughout pregnancy

Question 27

Which abx are safe in pregnancy?

Answer 27

amox, amoxi/clav, cephalexin, fosfomycin, ceftriaxone, nitrofurantoin in 1st and 2nd trimester

Question 28

Duration of treatment in breastfeding?

Answer 28

cystitis/asymptomatic: 7 days
pyelonephritis: 14 days

Question 29

1st line for mild-mod catheter-associated UTI?

Answer 29

FQ or Ceftriaxone x 7 days

Question 30

1st line for severe symptoms with catheter-associated UTI?

Answer 30

IV FQs, or ceftriaxone x 7-14 days

Question 31

1st line for candida UTIs?

Answer 31

fluconazole

Question 32

UTI in children < 2 years old?

Question 33

UTI in children > 2 years old?