UTI Flashcards
What are S&S of lower UTI?
Dysuria, nocturia, urgency, frequency, and suprapubuc heaviness
What are S&S of upper UTI?
fever, malaise, flank pain, N/V
What is the clinical presentation of UTI’s in elderly patients?
altered mental status, change in eating habits, GI symptoms
How do patients with indwelling catheters present clinically?
Flank pain and fever (not normally with lower tract infections symptoms )
What is causative bacterial agent in uncomplicated UTI’s?
E. coli 75% to 95%
What is bacterial agent in complicated UTI’s?
enterococcus faecalis and othr granm negative bacteria
Name the three treatments for outpatient tx of uncomplicated UTI’s?
Tx #1: 3 day course of TMP-SMX (Bactrim)-bactericidal
Tx #2:5 days of Nitrofurantoin
Tx #3: one dose of fosfomycin IM
What is special about Nitrofurantoin? (3)
- bacteria themselves seem to induce the power of nitro
- multi action: interferes with DNA, RNA, and cell wall synthesis
- bactericidal at therapeutic doses in urine
Which drugs should be reserved for suspected pyelonephritis?
Flouroquinilones
Cipro, Levofloxacin, tx for 3 days
What is alternative tx for UTI’s?
Cephalexin x 7 days
Augmentin x 3 days
Cefpodoxime x 3 days
How do you tx UTI in recurrent infection in short or long time period?
You can tx with the same abx if patient comes down with a UTI again in short time frame after being treated
Treat with a different abx if patient returns after a long period after given abx: possible resistance
What is MOA of nitrofurantoin?
inactivates bacterial ribosomes and stops the synthesis of proteins
What are ADE of TMP-SMX? (3)
SJS
renal failure
hematologic (neutropenia etc…)
What do you monitor on TMP-SMX?
BUN
Srcr
What are ADE of Nitrofurantoin? Monitor?
GI disturbances. BUN + Srcr
What are ADE with fosfomycin?
HA, angioedema, and diarrhea
use cautiously with hepatic issue pts.
What are ADE of Cipro, Levo?
hypersensitivity, confusion, tendonitis black box warning
What is best abx for prostatitis and pyelonephritis? Do they cover for P. aerginosa?
levo, cipro, yes
Can you use moxifloxacin for prostatitis and pyelonephritis? Why?
NO , inadequate urine concentration
What is ADE of Augmetin?
hypersensitivity
diarrhea
anaphylaxis
What abx is used for tx of uncomplicated cystitis?
Augmentin
T/F There are no advantages to using cephalosporins, they are more expensive and do not cover for enterocci
TRUE
How do you tx uncomplicated cystitis?
dont use ampcillin same as UTI NitroX 5 days fosfomyocin IM TMP-SMX 3 days
How do you tx UTI in pregnancy?
Cephalosporin x 7 days
Augmetin X 7 days
