Exam 3 - UTIs Flashcards Preview

Therapeutics V Spring 2019 (P3 Spring) > Exam 3 - UTIs > Flashcards

Flashcards in Exam 3 - UTIs Deck (28):
1

what are examples lower urinary tract infections?

cystitis (bladder)
urethritis (urethra)
prostate (prostatitis)

2

what are examples of upper urinary tract infections?

pyleonephritis (kidney)

3

definition of uncomplicated UTI?

a young female with no structural/functional abnormalities

4

definition of complicated UTI?

some blocking the urine flow
(in men, old people, or pregnant people)

5

Definition of Recurrent UTI?

>/= 2 UTIs in 6 mos
or
>/= 3 UTIs in 1 year

6

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)

7

Definition asymptomatic bacteriuria?

common in pts > 65 yo
significant bacteriuria (>10^5) but NO symptoms

8

when to treat asymptomatic bacteriuria

if pregnant woman

9

Criteria for Significant Bacteriuria:
_____ CFU bacteria/mL in a symptomatic male

>/= 10^4

10

Criteria for Significant Bacteriuria:
_____ CFU bacteria/mL in asymptomatic individuals on two consecutive specimens

>/= 10^5

11

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

12

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)

13

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)

14

Common ADEs for acute pyelonephritis?

FLANK pain!
more systemic symptoms (fever/chills)

15

Abx options for UTIs?

Macrobid
SMX-TMP
fosfomycin
FQs (not first line)
beta lactams (not first line)

16

Side effects of macrobid?

pulmonary toxicity****
antacids decrease rate of absorption
hepatoxicity
peripheral neuropathy

17

Contraindications for macrobid?

CrCl < 30 mL/min
Pregnant women at term (38 - 42 wks)
neonates < 1 month of age

18

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

19

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

20

How long to treat UTI?
If pregnant?

7 days!

21

what UTI drugs should be avoided in pregnancy?

Macrobid (at term)
and SMX-TMP (in last trimester due to hyperbilirubinemia/kernicterus)

22

Post coital therapy for UTI prevention?

1 dose SMX-TMP after sex (only 1 tab per day max)

23

Prostatitis Treatment - Primary empiric regimen:
Acute/Uncomplicated - Enterobacteriaceae?

Cipro or Levofloxacin
(or SMX/TMP)

24

Prostatitis Treatment - Primary empiric regimen:
Acute/Uncomplicated - Enterococcus species?

ampicillin
vanc
(or linezolid or levofloxacin)

25

Prostatitis Treatment - Primary empiric regimen:
Acute/Uncomplicated - Pseudomonas

ciprofloxacin
(pip/tazo)

26

Prostatitis Treatment - Primary empiric regimen:
Acute/Uncomplicated - FQ-R enterobacteriacease

ertapenem (ceftriaxone/meropenem)

27

Prostatitis Treatment - Primary empiric regimen:
Acute/Uncomplicated - ESBL/Amp-C producing enterobacteriaceae?

ertapenem (cefepime)

28

Prostatitis Treatment - Primary empiric regimen:
Acute/Uncomplicated - FQ-R Pseudomonas

Imipenem (meropenem)