UTI

Question 1

Host mech against uti?

Answer 1

• Micturition w increased diuresis
• Antibac prop of urine and bladder secretions
• antiadherence mech of bladder except bac w pili
• inflam response w polymorphonucleaur leukocytes(PMN) - phagocytosis

Question 2

Prevention of uti

Answer 2

Drink more water
Urinate frequently and shortly aft sex
Wipe from front to back
Keep area dry
Stop unlub and spermicidal condoms

Question 3

Abx for Cystitis in women

Answer 3

First line:
Cotrimoxazole 800/160 bid x3d
Nitrofurantoin 50mg qds x5d
Fosfomycin 3g single dose

Alt:
(BLx5-7d) po cefuroxime 250mg bd
Po Amoxicillin-clavulanate 625mg bd
(Po FQ×3d)
Po cipro/levo 250mg bd/od

Complicated: longer duration ×7-14d
Fosfomycin 3dose

Question 4

CA pyelonephritis in women

Answer 4

PO FQ
cipro 500 bd x7d
Levo 750 od x5d
PO cotrimoxazole bd x 10-14d
PO BL x 10-14d
Cefuroxime 250-500 bd
Amoxicillin-clavulanate 625 TDS

SEV: (IV)
Iv cipro 400mg bd/ cefazolin 1g q8h/ Amoxicillin-clavulanate 1.2g q8h and/or iv/im gentamicin 5mg/kg(gn + esbl)
- switch to oral if improve

Question 5

Cystitis in men

Answer 5

If no concern for prostatitis, same as women
If have concerns or pyelonephritis,
PO cipro 500mg bd x 10-14d or
PO cotrimoxazole bd
If prostatitis confirmed - 6w

Question 6

Healthcare associated uti abx

Answer 6

Cefepime 2g q12h +/- amikacin 15mg/kg/d
Meropenem 1g q8h or imipenem 500mg q6h
Po Levo 750mg od
Po cipro 500mg bd
Duration 7-14d

Question 7

Catheter ass uti abx

Answer 7

Cefepime 2g q12h +/- amikacin 15mg/kg/d (1 dose/daily)
Meropenem 1g q8h or imipenem 500mg q6h
Po Levo 750mg od × 5d(for mild CA UTI)
Po cotrimoxazole bid x3d (for women <65 wo Upper uti)
Duration: 7d and 10-14 for delayed reponse