Exam 3 - UTIs Flashcards
(28 cards)
what are examples lower urinary tract infections?
cystitis (bladder)
urethritis (urethra)
prostate (prostatitis)
what are examples of upper urinary tract infections?
pyleonephritis (kidney)
definition of uncomplicated UTI?
a young female with no structural/functional abnormalities
definition of complicated UTI?
some blocking the urine flow
in men, old people, or pregnant people
Definition of Recurrent UTI?
> /= 2 UTIs in 6 mos
or
/= 3 UTIs in 1 year
definition of reinfection vs recurrent UTIs
reinfection: occurs over 2 weeks after treatment (will be a diff bug)
recurrent: occurs within 2 weeks (will be same bug form first infection)
Definition asymptomatic bacteriuria?
common in pts > 65 yo significant bacteriuria (>10^5) but NO symptoms
when to treat asymptomatic bacteriuria
if pregnant woman
Criteria for Significant Bacteriuria:
_____ CFU bacteria/mL in a symptomatic male
> /= 10^4
Criteria for Significant Bacteriuria:
_____ CFU bacteria/mL in asymptomatic individuals on two consecutive specimens
> /= 10^5
Criteria for Significant Bacteriuria:
_____ CFU coliforms/mL in a symptomatic females
or
_____ CFU noncoliforms/mL in a symptomatic females
> /= 10^2 coliforms
> /= 10^5 noncoliforms
2 pathogenesis ways for UTIs?
ascending pathway (colonic pathway enters urethra/vagina --> bladder = colonization) OR hematogenous spread (infection comes from a distal site of infection)
Host defense mechanisms against UTIs?
- Urine – low pH, high urea, osmolality extremes
- Flushing/voiding/urinating
- when bacteria into bladder – you diuresis more than normal to get it out
- urinary mucus prevents adherence of bacteria
- lactobacillus present in vagina (related to estrogen)
Common ADEs for acute pyelonephritis?
FLANK pain!
more systemic symptoms (fever/chills)
Abx options for UTIs?
Macrobid SMX-TMP fosfomycin FQs (not first line) beta lactams (not first line)
Side effects of macrobid?
pulmonary toxicity**
antacids decrease rate of absorption
hepatoxicity
peripheral neuropathy
Contraindications for macrobid?
CrCl < 30 mL/min
Pregnant women at term (38 - 42 wks)
neonates < 1 month of age
How long to treat UTI? Macrobid: SMX-TMP: Fosfomycin: FQs: beta-lactams:
macrobid: 5 days SMX-TMP: 3 days Fosfomycin: 1 day (one dose) FQs: 3 days beta lactams: 3 - 7 days
How long to treat UTI?
If pt is complicated (diabetes, symptoms > 7 days, recent UTI, use of diaphragm, or > 65 yr old)
7 - 10 days of treatment
How long to treat UTI?
If pregnant?
7 days!
what UTI drugs should be avoided in pregnancy?
Macrobid (at term)
and SMX-TMP (in last trimester due to hyperbilirubinemia/kernicterus)
Post coital therapy for UTI prevention?
1 dose SMX-TMP after sex (only 1 tab per day max)
Prostatitis Treatment - Primary empiric regimen:
Acute/Uncomplicated - Enterobacteriaceae?
Cipro or Levofloxacin
or SMX/TMP
Prostatitis Treatment - Primary empiric regimen:
Acute/Uncomplicated - Enterococcus species?
ampicillin
vanc
(or linezolid or levofloxacin)
