Treatment Of UTI

Question 1

What may be purposes of using Abx wuth regards the urinary tract?

Answer 1

1. Prevention of UTI in high risk pateint (many recurrent infections)
2. Management of active infection
3. Suppression of bacterial growth in person when bacteria can’t be eradicated (patient with obstruction)

Question 2

List non-pharmacological therapy for UTI

Answer 2

1. Large volumes of cranberry juice: dec number of UTIs over a yr in patients with recurrent UTIs
2. Probiotics dec vaginal pH & dec growth of pathogenic organisms
3. Topical estrogen dec incidence in postmenopausal women

Question 3

The FQ NOT used in UTI is……

Answer 3

Moxifloxacin

Question 4

What is the dose & duration of the following in case of uncomplicated LUTI:
1. TMP/SULF
2. Amox/clv

Answer 4

1. 2 DS tablets single dose OR 1 DS tablet twice/day for 3 days
2. 6x500 mg single dose OR 500 mg/8hr for 3 days

Question 5

Compare Advs of 1-day vs 3-day therapy in uncomplicated LUTI

Answer 5

1-day: better compliance, less adverse events & drug interactions
3-day: higher cure rates

Question 6

List possible AEs of TMP/SULF

Answer 6

Allergic reactions: Rash/Stevens-Johnson syndrome

Question 7

Complicated LUTI duration of treatment is (usually)……..

Answer 7

7-10 days

Question 8

In UUTI, therapeutic conc should be reached in………, duration of treatmen is……

Answer 8

Blood stream & urinary tract
14 days

Question 9

Duration of treatment in male with UTI is……..

Answer 9

2 weeks nay reach 6 weeks in failure especially in prostatic source is suspected

Question 10

Duration of treatment of UTI in pregnancy is…….

Answer 10

7 days

Question 11

Why are pregnant females at risk for UTI?

Answer 11

1. Severe dilation of renal plevis & ureters, dec ureteral peristalsis & reduced bladder tone occur, during pregnancy urinary stasis & reduced defenses against reflex of bacteria to kidney
2. Inc urine content of AA, vitamins & nutrients encourages bacterial growth

Question 12

List effects of asymptomatic bacteriuria in PREGNANCY

Answer 12

Prematurity, low birth weight, stillbirth

Question 13

List Abx effective in pregnancy

Answer 13

Sulfonamide (not in 3rd trimester), amoxicillin, amox/clav, cephalexin, nitrofurantoins

Question 14

Mention Abx CI in pregnancy & why?

Answer 14

1. Tetracycline: tertogenic effects
2. Sulfonamides: not used in 3rd trimester for risk of kernictrus
3. FQ: inhibit cartilage & bone development in new bone

Question 15

Describe follow-up of UTI in pregnancy

Answer 15

Urine culture 1-2 wks after completing therapy and then monthly until gestation is complete

Question 16

What are guidelines for catheterized patients?

Answer 16

1. Prophylactic systemic Ab in patients with short-term catheter reduces incidence of infection over 4 to 7 days
2. When bacteriuria occurs in asymptomatic individually catheter should be removed as soon as possible
3. Re-catheterized patient with new catheter if the previous catheter is greater than 2 wks
4. Management of infection: optimal duration of therapy is unknown

Question 17

What are guidelines for UTI with sexual intercourse?

Answer 17

Post-coital Ab prophylaxis, a single nightly dose of nitrofurantoin (50 mg) or cephalexin + voiding after intercourse before medication