UTIs

Question 1

UTIs - common organisms

Answer 1

e.coli (80%)

proteus/klebsiella

Question 2

UTI - clinical presentation

Answer 2

pain/burning
increased frequency
suprapubic pain
hematuria

Question 3

UTI - Labs

Answer 3

blood cultures if upper UTI
midstream UA (bacteria, WBC, blood, leukocyte esterase, nitrates)
Urine gram stain (narrows down to + or - until cultures come back)
Urine C&S - if pyelonephritis suspected

Question 4

Acute Uncomplicated Bacterial Cysititis (UTI) - s/s

Answer 4

dysuria
frequency
urgency

Question 5

Acute UTI - treatment length

Answer 5

abx x 3 days are as effective as 7 days

Question 6

Uncomplicated UTI - DOC

Answer 6

Bactrim or Macrobid

Question 7

Who should not take Bactrim?

Answer 7

sulfonamide allergy
G6PD
3rd trimester (because  of G6PD)
resistance prevalence >20%
poor renal function

Question 8

Counseling - Macrobid

Answer 8

take with food

may change color of urine (brown)

Question 9

Who should not take Macrobid?

Answer 9

close to delivery (b/c of G6PD possibility)
CrCl<60
G6PD

Question 10

Which two drugs are classic drugs to avoid in G6PD?

Answer 10

Macrobid and Bactrim

Question 11

Acute Pyelonephritis - what does “uncomplicated” mean?

Answer 11

can tolerate po (no n/v)
not pregnant
can treat as outpatient

Question 12

Acute Pyelonephritis - DOC

Answer 12

FQ - Cipro or Levo

if nauseated - IV Ceftriaxone

Question 13

Acute Pyelonephritis - IV regimens

Answer 13

Rocephin

Question 14

Chronic pyelonephritis - treatment

Answer 14

same as acute but longer

Question 15

Catheter Associated UTI - how long to treat?

Answer 15

at least for 7 days if prompt response

10-14 days if response is delayed

Question 16

Asymptomatic bacteriuria

Answer 16

generally no treatment unless pregnant (b/c of pyelonephritis risk)
AMX or Bactrim (1st/2nd trimester) or nitrofurantoin

Question 17

UTI in children - duration of treatment

Answer 17

7 days, not 3

Question 18

UTI in children - Lower UTI (> 6 mos.)

Answer 18

Bactrim or AMX

Question 19

UTI in children - Upper UTI

Answer 19

AMP + Gent IV

Question 20

Dysuria - DOC

Answer 20

Phenazopyridine (Pyridium) - not an abx

Question 21

Counseling - Phenazopyridine (Pyridium)

Answer 21

turns urine reddish orange

preg B

Question 22

UTI - Pregnancy

Answer 22

AMX or Bactrim (1st/2nd tri) or Macrobid x 7 >6 months Bactrim or AMX

Question 23

UTI in children - Lower UTI (<6 mos.)

Answer 23

Bactrim or Amp