UTI

Question 1

Cystitis

Answer 1

LOWER urinary tract
-No systemic sx

Bugs
-E. coli
-Proteus
-Klebsiella

Sx: burning, frequency, urgency, dysuria

Question 2

Pyelonephritis

Answer 2

UPPER urinary tract
-Systemic sx
(fever 38+, flank pain, leukocytosis, NV)

Same bugs + pseudomonas, enterococci

Question 3

Cystitis TX

Answer 3

-Macrobid 100 mg PO BID x5d
-Fosfomycin 3 g x 1 dose
-Bactrim 1 DS BID x 3d (CI in sulfa allergy)

NOT FQ DUE TO RESISTANCE

Question 4

Pyelonephritis Tx

Answer 4

Outpatient:
-Levo 750 mg x5-7 days
-If FQ res >10% then do CTX 1 g IV then continue as above

NO MOXI CANNOT PENETRATE URINE SUFFICIENT ENOUGH

Inpatient:
-CTX
-Levo/cipro
-Resistance: Zosyn (if PM) or carbapenem (if ESBL suspected)
(recent abx use, healthcare exp, urinary instrumentation)

Question 5

AZO

Answer 5

Max 2d

CI in renal impairment/liver disease

Take with plenty of water - 8 oz

Only sx relief

Red-orange discoloration of urine

Question 6

Pregnancy

Answer 6

Cephalexin or augmentin preferred

Allergy: Fosfomycin

Macrobid/Bactrim/FQ not preferred due to potential fetal risk