Exam 6 - UTI Flashcards
(45 cards)
Lower UTI =
Bladder, Urethra
Upper UTI =
Kidney
Lower UTI involves _____ and ____, while an Upper UTI involves _____ only.
Lower UTI involves BLADDER and URETHRA, while an Upper UTI involves KIDNEY only.
“Simple” UTI =
No underlying problems
“Complicated” UTI =
Presence of predisposing condition
Which type of UTI (simple or complicated) requires longer duration of treatment?
COMPLICATED
Name risk factors for UTI infection (6).
1) Age - younger children and older males
2) Sex - both genders
3) Anatomical abnormalities - bad kidney
4) Instrumentation - catheter
5) Trauma
6) Medications - anticholinergics decrease urine flow; SGLT2 inhibitors
Name Community Acquired UTI bacteria (4).
1) E. coli
2) Proteus mirabilis
3) Staph. saprophyticus
4) Klebsiella spp.
Name Hospital Acquired UTI bacteria (6).
1) Klebsiella spp.
2) Enterococcus faecalis
3) Pseudomonas aer.
4) E. coli
5) Staphylococcus a.
6) Candida
What is the number 1 cause of community acquired UTI?
E. coli
List Lower UTI s/s (7).
1) Dysuria
2) Polyuria
3) Urgency
4) Nocturia
5) Fever - possibly, but not usually
6) Confusion - elderly pts
7) Hematuria
List Upper UTI s/s (9).
1) Flank pain
2) Malaise
3) Fever
4) Abdominal pain
5) Mental status changes/confusion - elderly
6) N/V
7) Elevated WBC
8) PCT positive
9) Hematuria
T/F: You do not treat asymptomatic UTI, unless it is children or pregnancy.
TRUE
Name diagnostic features for UTI UA.
>10 WBC's/hpf >10^5 bacteria/mL urine \+nitrites \+leukocytes \+bacteria
Name the pts that would be classified as Uncomplicated UTI (6).
1) Immunocompetent
2) Absence of co-morbidities
3) No known urologic problems - polycystic kidney, neurogenic bladder, catheter
4) Non-pregnant
5) Premenopausal
6) Controlled DM (A1c <8)
Name pts that would be classified as Complicated UTI (8).
1) Pyelonephritis
2) Immunocompromised
3) Hx of adolescent UTIs
4) PG
5) Underlying metabolic disorder
6) Urologic abnormality (kidney stones, atonic bladder, strictures, etc.)
7) Pre-adolescent or postmenopausal
8) Males <20 or >50
What two antibiotics is ESBL producing E. coli sensitive to?
1) Ertapenem - IV only
2) Fosfomycin - expensive
When is single dose therapy indicated in the treatment of UTI?
Acute, uncomplicated lower UTI
Name the contraindications to single dose therapy for UTI (6).
1) PG
2) Males
3) Children
4) Resistant/relapsing/re-infection
5) Pyelonephritis
6) Complicated infection
Name the medication used in single dose therapy for UTIs.
Fosfomycin tromethamine (Monurol) -Has a lot of GI upset (take on empty stomach)
Name the indications for 3-day therapy for UTIs (3).
1) Healthy men aged 20-40
2) Girls over 5 years w/ symptoms
3) Healthy, non-pregnant women with first or second episode
Name the 2 drugs of choice for UTIs.
1) TMP/SMX DS (Bactrim DS) PO BID x 3 days
2) Nitrofurantoin macrocrystals 100 mg PO BID x 5 days
- Not for pts with CrCl <50 mL/min
Name the indications for 7-day therapy for UTIS (5).
1) Men >40 years of age
2) pre-existing renal disease
3) PG
4) re-infection or resistant infection
5) children not indicated for 3 day therapy
Name the 3 drugs of choice for 7-day therapy for UTIs.
1) TMP/SMX DS (Bactrim DS) PO BID
2) Amox/Clav (Augmentin) 875 mg PO BID
OR Amoxicillin 500 mg PO TID
3) Nitrofurantoin 100 mg PO BID
