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BCPS > UTI > Flashcards

UTI Flashcards

1
Q

When to treat asymptomatic bacteruria

A
  1. Pregnant women (4-7 days)
  2. Undergoing endoscopic urologic procedure (1-2 doses)
  3. Renal transplant recipients in first 30 days post transplant
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2
Q

UA - nitrite positive indicates what bacteria

A

E. coli
Proteus
Klebsiella

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3
Q

UA with casts indicates what

A

pyelonephritis

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4
Q

Uncomplicated cystitis recommended therapy

A
  1. Bactrim DS BI x3 days (avoid if resistance >20% or used for UTI in past 3 months)
  2. Nitrobid 100mg BID x5 days (avoid CrCl <30)
  3. Fosfomycin 3gm x1
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5
Q

Uncomplicated cystitis alternative therapy

A
  1. B-lactams x5-7 days (augmentin, cefdinir, cefaclor, cephalexin, cefpodoxime)
  2. FQ (cipro or levo) x3 days
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6
Q

Uncomplicated pyelonephritis outpatient therapy

A
  1. Bactrim DS BID x14 days
  2. Levaquin 750mg x5 days or cipro 500mg BID x7 days
  3. B lactams (augmentin, cefdinir, cefaclor, cephalexin, cefpodoxime) x10-14 days
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7
Q

Uncomplicated pyelonephritis outpatient therapy if uropathogen resistance >10%

A

Initial dose of IV, long-acting B lactam or once-daily aminoglycoside

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8
Q

Complicated UTI outpatient therapy

A
  1. Bactrim DS BID x7-14 days
  2. Levaquin 750mg daily x5 days or cipro 500mg BID x7 days
  3. B lactams x7-14 days (augmentin, cefdinir, cefaclor, cephaexin, cefpodoxime)
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9
Q

Complicated UTI Inpatient therapy

A

Ceftriaxone, FQ, aminoglycoside x5-14 days

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10
Q

When anti-pseudomonal B lactam needed for complicated UTI inpatient

A

Recent hospitalization
Urinary catheter
Living in nursing home

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11
Q

Complicated UTI

A
  1. Males
  2. Hospital acquired
  3. Pregnancy
  4. Anatomic abnormality of urinary tract
  5. Poorly controlled diabetes
  6. Recent antimicrobial use
  7. Indwelling catheter
  8. Recent urinary tract instrumentation
  9. Immunosuppression
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12
Q

UTI in pregnancy therapy

A
  1. Augmentin x3-7 days
  2. Nitrofurantoin x5-7 days (avoid first trimester)
  3. Cephalexin or cefpodoxine x3-7 days
  4. Fosfomycin
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13
Q

Avoid these ABX for pregnant women

A
  1. FQs
  2. Tetracyclines
  3. Aminoglycosides
  4. Bactrim (especially late 3rd trimester)
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14
Q

Treatment duration for UTI relapse

A

-Infection with same organism within 14 days of discontinuing antibiotics

May need longer (2 week) treatment but assess why the first med failed

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15
Q

UTI prophylaxis if 2 or fewer UTIs in 1 year

A

Patient-initiated therapy (3 day treatments)
Reassess need for ppx every 6-12 months

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16
Q

UTI prophylaxis if 3 or more UTIs in 1 year and related to sex

A

Postintercourse prophylaxis

Bactrim SS
Cephalexin 250mg
Nitrofurantoin 50mg

17
Q

UTI prophylaxis if 3 or more UTIs in 1 year not related to sex

A

Daily or 3x weekly prophylaxis

Trimethoprim 100mg
Bactrim SS
Cephalexin 250mg
Nitrofurantoin 50mg

18
Q

Treatment if patient with short-term indwelling catheter has asymptomatic bacteriuria

A

No antibiotics

19
Q

Catheter related UTI, symptomatic therapy, short term indwelling catheter

A

7 days of ABX
Increase to 10-14 days if delayed response

Levaquin x5 days if not severely ill
3 days if women <65 with catheter removed, no pyelo symptoms

20
Q

Long-term indwelling catheter asymptomatic bacteriuria

A

No antibiotics
Do not change catheter

21
Q

Long-term indwelling catheter symptomatic bacteriuria

A

7 days to prevent resistance
Catheter replacement might be indicated

22
Q

Acute bacterial prostatitis

A

Gram negative organisms

  1. Bactrim
  2. FQs

2-4 weeks, possible 2 more weeks if remain symptomatic

23
Q

Chronic bacterial prostatitis

A
  1. Bactrim
  2. FQs

1-4 months

24
Q

Epididymitis - sexually transmitted

A

C. trachomatis or N. gonorrheae

Ceftriaxone 500mg (1000mg if >150kg) IM + doxycycline 100mg BID x10 days

Use levofloxacin instead of doxy if anal sex

25
Q

Epididymitis - non sexually transmitted

A

Enteric gram-negative organisms

Common in med with BPH or prostate biopsy, vasectomy, or other urinary tract procedure

Levaquin 500mg daily x10 days

BCPS (27 decks)

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