UTIs Flashcards
UTIs - common organisms
e.coli (80%)
proteus/klebsiella
UTI - clinical presentation
pain/burning
increased frequency
suprapubic pain
hematuria
UTI - Labs
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
Acute Uncomplicated Bacterial Cysititis (UTI) - s/s
dysuria
frequency
urgency
Acute UTI - treatment length
abx x 3 days are as effective as 7 days
Uncomplicated UTI - DOC
Bactrim or Macrobid
Who should not take Bactrim?
sulfonamide allergy G6PD 3rd trimester (because of G6PD) resistance prevalence >20% poor renal function
Counseling - Macrobid
take with food
may change color of urine (brown)
Who should not take Macrobid?
close to delivery (b/c of G6PD possibility)
CrCl<60
G6PD
Which two drugs are classic drugs to avoid in G6PD?
Macrobid and Bactrim
Acute Pyelonephritis - what does “uncomplicated” mean?
can tolerate po (no n/v)
not pregnant
can treat as outpatient
Acute Pyelonephritis - DOC
FQ - Cipro or Levo
if nauseated - IV Ceftriaxone
Acute Pyelonephritis - IV regimens
Rocephin
Chronic pyelonephritis - treatment
same as acute but longer
Catheter Associated UTI - how long to treat?
at least for 7 days if prompt response
10-14 days if response is delayed
Asymptomatic bacteriuria
generally no treatment unless pregnant (b/c of pyelonephritis risk)
AMX or Bactrim (1st/2nd trimester) or nitrofurantoin
UTI in children - duration of treatment
7 days, not 3
UTI in children - Lower UTI (> 6 mos.)
Bactrim or AMX
UTI in children - Upper UTI
AMP + Gent IV
Dysuria - DOC
Phenazopyridine (Pyridium) - not an abx
Counseling - Phenazopyridine (Pyridium)
turns urine reddish orange
preg B
UTI - Pregnancy
AMX or Bactrim (1st/2nd tri) or Macrobid x 7 >6 months Bactrim or AMX
UTI in children - Lower UTI (<6 mos.)
Bactrim or Amp
