UTI Flashcards
A$ bacteriuria - Rx?
No Rx - unless patient is pregnant or s/p TURP or s/p catheter
MCC of uncomplicated UTI
E coli
Other bugs that can cause uncomplicated UTI?
Klebsiella pneumoniae Enterococcus faecalis Proteus mirabilis Staphylococcus saprophyticus Streptococcus agalactiae
What defines “uncomplicated” UTI?
acute cystitis or pyelonephritis occurring in healthy premenopausal, nonpregnant women with no history of abnormal urinary tract
What defined acute uncomplicated cystitis?
- no fever, flank pain, or other suspicion for pyelonephritis
- ability to take oral medication
- premenopausal, nonpregnant woman
- no known urological abnormalities or comorbidities
What defines complicated UTI?
- all UTI in children and men
- all UTI that is not classified as uncomplicated in women, which includes but is not limited to infections in women with functional, metabolic, or anatomical abnormalities
- such as obstruction, urinary stone, pregnancy, male sex, diabetes, neurogenic bladder, renal insufficiency, or immunosuppression
What defines recurrent UTI
- relapse 2 weeks after initial infection
What sx suggest more of pyelonephritis than cystitis?
- flank pain
- fever > 38 degrees C (100.4 degrees F)
- nausea and vomiting
T of F: combination of dysuria and frequency without vaginal discharge or irritation appears to be highly predictive of UTI
T
T of F: empiric therapy for premenopausal women with strongly suspected uncomplicated cystitis is adequate
T
1st line for acute uncomplicated cystitis
- nitrofurantoin 100 mg orally twice daily for 5 days
- TMP-SMX (bactrim)
Rx for acute uncomplicated pyelonephritis?
- based on culture and susceptibility
Empiric Rx for acute uncomplicated pyelonephritis?
- FQ: cipro 500 mg po bid * 7 days or Levo
- IV ceftriaxone or IV aminoglycoside
- TMP-SMX
Following up for uncomplicated cystitis
- routine post-treatment urinalysis or urine culture not recommended in a$ patients
- If sx does not resolve by the end of treatment or recur - obtain urine cx and susceptibility again
Following up for Uncomplicated pyelonephritis
- If symptoms of pyelonephritis do not improve within 3 days, or resolve but then recur - repeat cx and susceptibility
- r/o urinary tract abnormalities and complications: renal U/S, CT
