UTI

Question 1

When to treat empirically? (Order culture but don’t wait for the results)

Answer 1

1-severely toxic

2-less than one year

Question 2

When do you postpone therapy till urine culture results?

Answer 2

1-non toxic

2-older than 1 year

3-no suspicion of UTI or Upper UT disease

Question 3

When do you use oral abx with close follow up?

Answer 3

1-Non toxic

2-Feeding well

3-Well hydrated

4-Compliance & follow up not problematic

Question 4

Hospitalize and close monitoring and supportive care if:

Answer 4

1-There is signs of urosepsis ,
Severe clinical illness
Significant dehydration
^ at any age

2-Suspected pyelonephritis

3-Less than 1 year with UTI

4-High risk children: with immunological impairment or known urological problem

Question 5

When do you use parenteral instead of oral?

And what would you use

Answer 5

1-vomiting

2-cant take oral

3-concern for compliance

1-ceftraxone cefotaxime

2-ampicillin (last option cause E coli is resistant) +- aminogylcoside (fear of renal dysfunction)

Question 6

Initial antimicrobial therapy is?

Answer 6

Oral!

1-sulfonamide (trimethoprim - sulfamethaxzole “tmp-smz”

Or

Sulfisoxazole)

2-cephalexin or cefixime(cephalosporin)

Question 7

Duration of AB therapy for

1-adolescent female with uncomplicated cystitis

2-febrile uti

3-pyelonephritis

Answer 7

1- 3 days

2- 7-14 days

3- 10-14

Question 8

Follow up & urine culture are recommended cause recurrence could happen within the first year
How would you follow up?

Answer 8

Monthly for 3 months

Then 3 months interval one each

Then 6 months interval 2 times

Question 9

Acute complications of UTI

Answer 9

1-Dehydration and hypovolemia

2-sepsis

3-renal abscess

4-acute kidney injury