UTI Flashcards
UTI: signs and sx
gross hematuria
LOWER: dysuria urgency frequency nocturia suprapubic heaviness costovertebral tenderness
UPPER: flank pain fever N/V malaise
UTI: laboratory test results
pyuria
nitrite positive urine
leukocyte esterase positive urine
antibody coated bacteria
UTI: elderly patient presentation
AMS
change in eating habits
GI sx
UTI: pts w/ indwelling catheters or neurologic disorders presentation
flank pain
fever
no lower tract sx
Common Dipstick Test
detects nitrite in urine
false negatives common due to:
- P.aeruginosa
- low urinary pH
- frequent voiding
- dilute urine
Leukocyte Esterase Dipstick Test
detects pyuria
What is the most reliable method of diagnosing a UTI?
urine culture
What microbes are associated w/ uncomplicated UTIs?
MC: E. coli
S. saprophyticus K. pneumoniae Proteus P. aeruginosa Enterococcus
What microbes are associated w/ complicated UTIs?
gram negative organisms
enterococcus faecalis
Recommended treatment for uncomplicated UTI
short course (3d) trimethroprim sulfamethoxazole OR 1 dose fosfomycin OR 5d nitrofurantoin
Recommended treatment for pyelonephritis or complicated infections
short course (3d)
ciprofloxacin or levofloxacin (fluoroquinolones)
**moxifloxacin does NOT work in urinary tract
Trimethoprim Sulfamethoxazole: ADEs
rash steven johnson syndrome renal failure photosensitivity hematologic
Nitrofurantoin: ADEs
GI intolerance
neuropathies
pulmonary reactions
Fosfomycin Trometamol: ADEs
diarrhea
HA
angioedema
Ciprofloxacin/Levofloxacin: ADEs
hypersensitivity photosensitivity GI sx dizziness confusion tendonitis