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ID > UTI/pyelonephritis > Flashcards

UTI/pyelonephritis Flashcards

1
Q

asymptomatic bacteriuria

A

significant bacteria but no symptoms

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2
Q

pyelonephritis

A

infection of the kidney

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3
Q

uncomplicated UTI

A

infections to pts who are healthy and have no structural or functional abnormalities of the urinary tract

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4
Q

complicated UTI

A

infections to pts who have abnormalities of their urinary tract, a stone, a catheter, obstruction, or neurologic deficit affecting flow

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5
Q

signs and symptoms of acute simple cystitis

A

dysuria
urinary incontinence
uinary urgency
urinary frequency
foul smelling urine
hematuria

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6
Q

signs and symptoms of complicated UTI/ pyelonephritis

A

sign and symptoms of ASC
chills
fever
flank plain
costovertebral angle tenderness
N/V
abdominal pain

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7
Q

diagnosis

A

get a UA
if positive w s/sx proceed with a urine culture

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7
Q

gold standard

A

culture with sensitivities

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7
Q

no UTI symptoms
not at risk population

A

no culture

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8
Q

no UTI symptoms
at risk population

A

culture

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9
Q

any UTI symptom
at risk population

A

culture

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10
Q

any UTI symptoms
not at risk

A

evaluate pyuria and contamination

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11
Q

any UTI symptoms
NOT at risk
pyuria (>10 WBC)
no contamination (<100 squamous cells)

A

culture

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12
Q

any UTI symptoms
at risk
no pyuria

A

no culture , strong predictor of no infection

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13
Q

any UTI symptoms
at risk
pyuria and contamination (>100 squamous cells)

A

no culture

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14
Q

two clinical instances where a pt with ASBU should be screened

A

pregnant women
-pyelonephritis
-premasture delivery
-low birth weight infant

prior urologic procedure
-risk of mucosal bleeding
-post bacteremia
-sepsis

15
Q

duration of therapy for pregnant women

A

4-7 days, shortest effective course

16
Q

abx in pregnancy
asymptomatic bacteriuria

A

cephalexin
amoxicillin
cefdinir
amoxicillin-clave
nitrofurantoin
Trim/sulf
fosfomycin

17
Q

duration of therapy for urologic procedure with mucosal bleeding risk

A

1-2 dose short course

18
Q

uncomplicated UTI management
first line

A

Nitrofurantoin x 5 days
–avoid in CrCl <30m ml/min

Trimethoprim/sulfamethoxazole x 3 days

Fosfomycin single dose

19
Q

uncomplicated UTI management
second line

A

oral bet lactam x 5-7days
– cephalexin, cefdinir

Flurooquinolones x 3 days
–cipro or levo

20
Q

cather-associated UTI are grouped within

A

complicated UTI

21
Q

complicated UTI management
first line

A

Trim/sulf (bactrim) x 7days

Levo 5-7 days

22
Q

complicated UTI management
second line

A

Nitrofurantoin 7-10 days
—avoid in pyelonephritis and Crcl <30

oral beta lactam x7days
–cephalexin, cefdinir

23
Q

Inpatient management of complicated UTI
first line

A

ceftriaxone 1 g daily

ertapenem 1 g daily if history of ESBL producing org

piper/tazo if pt has history of pseudomonas

24
Q

Inpatient management of complicated UTI
stepdowm/ second line

A

Nitrofurantoin 7day total cours including initial IV
–avoid in pyelonephritis of Crcl < 30)

trimethoprim/sulfamethaxazole 7days

oral beta lactase 7 days
–cephalexin, cefdinir, amoxicillin-clav

25
Q

inpatient management CAUTI
mild/moderate - treat as complicated UTI

A

Levo BID
TMP/SMX BID

alt; oral 3rd gen cephalorsporin
ceftriaxone

26
Q

inpatient management CAUTI
suspicion for more serous infections

A

PIPeracillin-lazobactam
cefrpime
ertapenem

alternative: aminoglycoside

27
Q

management of pyelonephritis
non-hospitalization

A

Ceftriaxone 1g one due to high e.coli resistance
–levo or cipro 5-7 days
TMP/SMX 10-14 days

28
Q

management of pyelonephritis
hospitalized

A

no MDR= ceftriaxone 1g q24hr

risk for MDR=
piperacillin-taz
cefepime
ertapenem (esbl history)
ahminoglycosides
vancomycin

29
Q

duration of the management of pyelonephritis

A

7 day course is considered effective when the bacteremia but ups to 14 days total may be needed w oral abx depending on agent

ID (27 decks)

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