UTI

Question 1

lower UTI symptoms

Answer 1

• dysuria, urgency, frequency, nocturia
• suprapubic heaviness/pain
• gross haematuria

Question 2

upper UTI symptoms

Answer 2

systemic symptoms of infection

Question 3

cystitis in women

Answer 3

• bladder
• 1st line
  ** PO co-trimoxazole
  ** PO nitrofurantoin
• alternative if allergy
  ** PO beta lactam 5-7 days (augmentin, cefuroxime)
  ** PO fluoroquinolones 3 days (cipro, levo)
• complicated cystitis
  ** 7-14 days
  ** fosfomycin

Question 4

elderly UTI symptoms

Answer 4

• altered mental state
• small GI symptoms, change in eating habits

Question 5

community acquired pyelonephritis in women

Answer 5

• kidney
• PO fluoroquinolones (cipro, levo)
• PO cotrimoxazole
• PO beta lactam (cefuroxime, augmentin)
• initial IV therapy
  ** hospitalisation/X tolerate PO drugs
  ** cipro, cefazolin, augmentin
  ** +/- gentamicin
  ** switch to oral after pt improve

Question 6

community acquired UTI for men

Answer 6

• cystitis wo prostatitis concern: same as complicated cystitis in women
• cystitis w concern of prostatitis/pyelonephritis: PO cipro or cotrimoxazole
• 10-14 days, 6 wks of confirmed prostatitis

Question 7

nosocomial/healthcare associated UTI

Answer 7

• broad spectrum beta lactam
• cefepim + amikacin
• imipenem/meropenem
• levo, cipro

Question 8

catheter associated UTI (CAUTI)

Answer 8

• replace catheter
• Abx only for systemic infection
  ** IV imipenem, meropenem
  ** IV cefepime +/- amikacin
  ** PO/IV levo
  ** PO cotrimoxazole
  ** 7 days, 10-14 if delayed response

Question 9

UTI in pregnancy

Answer 9

AVOID
- cipro
- cotrimoxazole in 1st and 3rd trimester
- nitrofurantoin

USE WITH CAUTION
- aminoglycosides

SAFE
- beta lactam

DURATION
- 4-7 days asymptomatic
- 14 days pylonephritis