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My2 renal > UTIs - treatment > Flashcards

UTIs - treatment Flashcards

1
Q

what is a-bacterial cystitis/ urethral syndrome

A

symptoms of a UTI but no cultures

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2
Q

what might abacterial cystitis/ urethral syndrome indicate

A

early phase of UTI, STI, urethral trauma from sexual intercourse

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3
Q

what management may be recommended for abacterial cystitis/ urethral syndrome

A

alkalising agents for urine

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4
Q

what is asymptomatic bacteriuria

A

significant bacteriuria but no symptoms

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5
Q

how do you manage asymptomatic bacteriuria and what is the exception

A

no antibiotic given - unless pregnant

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6
Q

why should you be careful prescribing antibiotics to catheter patients unnecessarily

A

catheter can become colonised with resistant organism which will cause symptoms

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7
Q

generally, what is prescribed for females with a lower UTI

A

nitrofurantoin or trimethoprim orally for 3 days

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8
Q

generally, what is prescribed for uncatheterised males with a lower UTI

A

cultures + nitrofurantoin or trimethoprim orally for 7 days

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9
Q

generally, what is prescribed for a complicated UTI/ pyelonephritis in a GP setting

A

co-amoxiclav or co-trimoxazole orally for 7 days

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10
Q

generally, what is prescribed for a complicated UTI/ pyelonephritis in a hospital setting

A

amoxicillin and gentamicin IV for 3 days

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11
Q

what is ESBL producing bacteria

A

extended spectrum beta-lactamase - enzymes produced by certain bacteria that can be found in the bowel

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12
Q

what antibiotics are ESBL producing bacteria resistant too

A

cephalosporins and almost all penicillins

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13
Q

what antibiotics can be used for ESBL producing bacteria

A

nitrofurantioin, pivmecillinam, IV temocillin, IV ertapenem

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14
Q

what is CPE and what gram are they

A

carbapenemase producing enterobacteriacaece gram -ive coliform

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15
Q

what antibiotics are CPE resistant too

A

all antibiotics

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16
Q

what are the first line antibiotics for UTIs

A

amoxicillin (IV or oral), trimpethroprim (IV cotrimoxazole), nitrofuranotoin (oral), gent (IV)

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17
Q

what are the second line antibiotics for UTI’s

A

pivmecillinam (oral), temocillin (IV), cefalexin (oral), co-amoxiclav, ciprofloxacin

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18
Q

when would 2nd line ab’s be used

A

if resistant organisms

19
Q

how does trimethoprim work

A

inhibits nucleic acid synthesis by inhibiting folic acid synthesis

20
Q

what organisms does trimethoprim work against

A

most coliforms eg E.coli, staph A (including MRSA)

21
Q

what organisms are resistant to trimethoprim

A

pseudomonas

22
Q

when should trimethoprim not be prescribed

A

first trimester of pregnancy

23
Q

why can nitrofurantoin only be used in UTI’s and not pyelonephritis

A

effective concentration only reached in bladder so ineffective in kidneys

24
Q

what organisms does nitrofurantoin work against

A

most coliforms eg E.coli, enterococci, MRSA, staph A

25
Q

what organisms does nitrofurantoin not work against

A

proteus or pseudomonas

26
Q

when should nitrofurantoin not be prescribed

A

late pregnancy, breast feeding, children <3 months - can cause neonatal haemolysis

27
Q

what organism is amoxillin used to treat for UTI’s

A

enterococcus faecalis - only use once cultures are done

28
Q

why is gentamicin dangerous

A

narrow therapeutic index

29
Q

what dangerous side effects can gentamicin cause

A

renal damage or CN VIII nerve damage

30
Q

what organisms is IV gent used for

A

(gram -ive coliforms) coliforms, pseudomonas, staph A

31
Q

what drug class does pivmecillinam belong too and how does it work

A

penicillin - inhibits cell wall synthesis

32
Q

what organisms is pivmecillinam given for

A

ESBL’s - gram -ive coliforms

33
Q

what organisms are resistant to pivmecillinam

A

staph, enterococci and pseudomonas

34
Q

what is used in patients who cannot tolerate gentamicin eg kidney failure

A

IV temocillin (penicillin)

35
Q

what drug class is cefalexin and how does it work

A

oral cephalosporin - inhibits cell wall synthesis

36
Q

when is cefalexin used

A

if resistant to amoxicillin and trimethoprim

37
Q

what organisms is cefalexin used for

A

coliforms and staph A (not MRSA)

38
Q

what is co-amoxiclav a combination of

A

amoxicillin and clavulanic acid

39
Q

what organisms are co-amoxiclav used for

A

coliforms, enterococci, staph A (not MRSA)

40
Q

what type of antibiotics are carbapenems

A

cell wall synthesis inhibitors (beta lactams)

41
Q

name 3 carbapenems

A

meropenem, ertapenem, imipenem

42
Q

what are carbapenems used to treat

A

pseudomonas

43
Q

what antibiotics are used to treat MRSA

A

tetracycline (eg doxy) or daptomycin

My2 renal (27 decks)

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