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Renal :') > UTI Treatment > Flashcards

UTI Treatment Flashcards

1
Q

what are the most common gram negative pathogens for uncomplicated UTIs?

A

UPEC and K. pneumoniae

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2
Q

what are the most common gram positive pathogens for uncomplicated UTIs?

A

S. saprophyticus and Enterococcus

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3
Q

what is the first line treatment for uncomplicated UTIs?

A

Nitrofurantoin OR TMP-SMX OR Fosfomycin

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4
Q

What is the first line treatment for uncomplicated UTIs in patients at risk for MDR gram negative infection?

A

Nitrofurantoin or Fosfomycin

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5
Q

what is the MOA of TMP-SMX?

A

inhibits bacterial DNA replication

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6
Q

what are the toxicities associated with TMP-SMX?

A

avoid with pregnancy and in patients with HIV

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7
Q

what is the MOA of fosfomycin?

A

inhibits bacterial cell wall synthesis

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8
Q

what is the MOA of nitrofurantoin?

A

inhibits bacterial protein synthesis, aerobic energy metabolism, and DNA,RNA, and cell wall synthesis

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9
Q

what are the toxicities associated with nitrofurantoin?

A

C. difficile superinfection, drug-induced liver injury, polyneuropathy, and pulmonary toxicity

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10
Q

what is second line treatment for uncomplicated UTIs?

A

one of the following beta-lactams: amoxicillin-Clavulanate or Cephalosporins

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11
Q

what is the MOA of cephalosporins?

A

they disrupt bacterial cell wall synthesis

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12
Q

what are the first generation cephalosporins used as a second line treatment for uncomplicated UTIs?

A

cephalexin and cefadroxil

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13
Q

what are the third generation cephalosporins used for second line treatment of uncomplicated UTIs?

A

cefpodoxime and cefdinir

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14
Q

what is the third-line treatment for uncomplicated UTIs?

A

fluoroquinolones: ciprofloxacin or levofloxacin

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15
Q

what are the common adverse effects of fluoroquinolones:levofloxacin?

A

tendonitis and tendon rupture, CNS effects, exacerbation of myasthenia gravis

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16
Q

which of the fluoroquinolones are the most potent against gram negative bacilli?

A

ciprofloxacin

17
Q

what are the indications of levofloxacin?

A

uncomplicated UTI, acute pyelonephritis, or prostatitis

18
Q

what is the first line treatment for uncomplicated pyelonephritis?

A

ciprofloxacin OR levofloxacin (so start off with fluoroquinolones right off the bat)

19
Q

if a patient has an uncomplicated pyelonephritis but resistance to fluoroquinolones, what is recommended?

A

an initial dose of ceftriaxone or aminoglycoside 24-dose

20
Q

what is an alternative first line treatment for an uncomplicated case of pyelonephritis?

A

TMP-SMX (if susceptibility is unknown, then initial dose of ceftriaxone OR aminoglycoside 24 hour dose is recommended

21
Q

what are the most common gram negative pathogens to cause complicated UTI?

A

UPEC and K. pneumoniae

22
Q

what are the most common gram positive pathogens to cause complicated UTIs?

A

enterococcus

23
Q

what is the first line treatment for patients with a complicated UTI but not requiring intensive care or suspected obstruction?

A

ceftriaxone, piperacillin-tazobactam, ciprofloxacin, OR levofloxacin

24
Q

how do you treat a patient with a complicated UTI who is at risk for MDR infection?

A

piperacillin-tazobactam, imipenem, meropenem, OR doripenem

25
Q

what should you add to a patients treatment for a complicated UTI if you suspect they may have a drug-resistant gram positive infection?

A

vancomycin, daptomycin, OR linezolid

26
Q

what is the first line treatment for patients with a complicated UTI and who require intensive care and/or suspect obstruction?

A

imipenem, meropenem, OR doripenem AND vancomycin

27
Q

how do you treat catheter associated UTI?

A

as a complicated UTI unless they are asymptomatic, then you do not treat

28
Q

how do you treat penicillin susceptible cystitis due to enterococci?

A

amoxicillin OR IV ampicillin

29
Q

how do you treat penicillin resistant cystitis due to enterococci?

A

nitrofurantoin, doxycycline, linezolid, or chloramphenicol

30
Q

how do you treat vancomycin resistant cystitis due to enterococci?

A

nitrofurantoin, doxycycline, linezolid, chloramphenicol, OR daptomycin

31
Q

how do you treat patients with candida UTI with an indwelling catheter?

A

first line: change the catheter, then if persists: fluconazole OR amphotericin B

32
Q

how do you treat patients with candida UTIs without an indwelling catheter?

A

fluconazole

33
Q

how do you treat pyelonephritis due to candida?

A

fluconazole

34
Q

when should antibiotic UTI prophylaxis be used and what is it?

A

only in women with frequently recurring UTIs (>2 in 6 months); TMP-SMX or nitrofurantoin

Renal :') (16 decks)

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