UTIs - treatment Flashcards
(43 cards)
what is a-bacterial cystitis/ urethral syndrome
symptoms of a UTI but no cultures
what might abacterial cystitis/ urethral syndrome indicate
early phase of UTI, STI, urethral trauma from sexual intercourse
what management may be recommended for abacterial cystitis/ urethral syndrome
alkalising agents for urine
what is asymptomatic bacteriuria
significant bacteriuria but no symptoms
how do you manage asymptomatic bacteriuria and what is the exception
no antibiotic given - unless pregnant
why should you be careful prescribing antibiotics to catheter patients unnecessarily
catheter can become colonised with resistant organism which will cause symptoms
generally, what is prescribed for females with a lower UTI
nitrofurantoin or trimethoprim orally for 3 days
generally, what is prescribed for uncatheterised males with a lower UTI
cultures + nitrofurantoin or trimethoprim orally for 7 days
generally, what is prescribed for a complicated UTI/ pyelonephritis in a GP setting
co-amoxiclav or co-trimoxazole orally for 7 days
generally, what is prescribed for a complicated UTI/ pyelonephritis in a hospital setting
amoxicillin and gentamicin IV for 3 days
what is ESBL producing bacteria
extended spectrum beta-lactamase - enzymes produced by certain bacteria that can be found in the bowel
what antibiotics are ESBL producing bacteria resistant too
cephalosporins and almost all penicillins
what antibiotics can be used for ESBL producing bacteria
nitrofurantioin, pivmecillinam, IV temocillin, IV ertapenem
what is CPE and what gram are they
carbapenemase producing enterobacteriacaece gram -ive coliform
what antibiotics are CPE resistant too
all antibiotics
what are the first line antibiotics for UTIs
amoxicillin (IV or oral), trimpethroprim (IV cotrimoxazole), nitrofuranotoin (oral), gent (IV)
what are the second line antibiotics for UTI’s
pivmecillinam (oral), temocillin (IV), cefalexin (oral), co-amoxiclav, ciprofloxacin
when would 2nd line ab’s be used
if resistant organisms
how does trimethoprim work
inhibits nucleic acid synthesis by inhibiting folic acid synthesis
what organisms does trimethoprim work against
most coliforms eg E.coli, staph A (including MRSA)
what organisms are resistant to trimethoprim
pseudomonas
when should trimethoprim not be prescribed
first trimester of pregnancy
why can nitrofurantoin only be used in UTI’s and not pyelonephritis
effective concentration only reached in bladder so ineffective in kidneys
what organisms does nitrofurantoin work against
most coliforms eg E.coli, enterococci, MRSA, staph A
