UTI's

Question 1

How do elderly patient’s commonly present with UTI’s?

Answer 1

1. AMS
2. Changes in eating habits
3. GI sx’s

Question 2

How do patient’s with indwelling catheters or neuro disorders commonly present with UTI’s?

Answer 2

1. Flank pain
2. Fever
3. Commonly won’t have lower tract sx’s

Question 3

What does a Common dipstick test detect?

Answer 3

Presence of nitrites

Question 4

Causes for a false-negative urine dipstick? (common)

Answer 4

1. P.aeruginosa- Do not reduce nitrates
2. Dilute urine
3. Urinary pH
4. Frequent voiding

Question 5

What does leukocyte esterase dipstick test detect?

Answer 5

pyuria

Question 6

What is the most reliable diagnostic method for UTI’s?

Answer 6

Urine culture

Question 7

Uncomplicated UTI treatment

Answer 7

1. Trimethoprim-Sulfamethoxazole (Bactrim) x3 days
2. One dose of Fosfomycin
3. Nitrofurantoin x 5 days

Question 8

Complicated or suspected Pyelonephritis treatment

Answer 8

Fluoroquinolones x3 days:

1. Ciprofloxacin
2. Levofloxacin

Question 9

What is TMP-SMX highly effective against?

Answer 9

Most aerobic enteric bacteria

Question 10

What is TMP-SMX not effective against?

Answer 10

P. aeruginosa

Question 11

TMP-SMX ADEs

Answer 11

1. Rash
2. Steven-Johnson Syndrome
3. Photosensitivity
4. Renal failure
5. Hematologic: Neutropenia, anemia

Question 12

What is the main advantage of Nitrofurantoin

Answer 12

Lack of resistance even after long courses of therapy

Question 13

Nitrofurantoin ADE’s

Answer 13

1. GI intolerance
2. Pulmonary rxns
3. Neuropathies

Question 14

Fosfomycin trometamol ADEs

Answer 14

1. Headache
2. Angioedema
3. Diarrhea

Question 15

What are the advantages of Fosfomycin trometamol

Answer 15

1. Single-dose therapy for uncomplicated infections

2. Low levels of resistance

Question 16

Who do you need caution use of Fosfomycin trometamol?

Answer 16

Patients with hepatic dysfunction

Question 17

Fluoroquinolones (Ciprofloxacin and Levofloxacin) ADE’s

Answer 17

1. Skin- Hypersensitivity, Photosensitivity
2. GI sx’s
3. Neuro-Dizzines, Confusoin
4. Tendonitis-Black Box warning

Question 18

What is the main advantage of Fluoroquinolones?

Answer 18

Greater spectrum of activity= + P. aeruginosa coverage

Question 19

What are Fluoroquinolones effective in treating?

Answer 19

1. Pyelonephritis

2. Prostatitis

Question 20

Who should we avoid treating with Fluoroquinolones?

Answer 20

1. Pregnant women

2. Children

Question 21

What is the preferred treatment for uncomplicated cystitis? Why?

Answer 21

Amoxicillin-Clavulanate (Augmentin)

D/T increasing E. coli resistance

Question 22

Amoxicillin-Clavulanate (Augmentin) ADE’s

Answer 22

1. Hypersensitivity: Rash, anaphylaxis
2. Diarrhea
3. Superinfection
4. Seizure

Question 23

Cephalosporins (Cefaclor

Cefpodoxime-proxetil) ADE’s

Answer 23

1. Hypersensitivity: Rash, anaphylaxis
2. Diarrhea
3. Superinfection
4. Seizure

Question 24

Disadvantages of Cephalosporins (Cefaclor

Cefpodoxime-proxetil)

Answer 24

1. No major advantage of these over other agents

2. Not active against enterococci

Question 25

Who do need avoid treating with TMP-SMX with?

Answer 25

Avoid in third trimester of pregnancy

Question 26

Lactobacillus possible advantages

Answer 26

Help keep vaginal pH in normal range to regulate genitourinary bacteria and prevent UT’s

Question 27

POSSIBLE clinical benefits of cranberry juice

Answer 27

Decreases adherence of bacteria to bladder epithelial cells

Possible clinical benefit in sexually active women w/ recurrent UTI’s

Question 28

Main benefit of Phenazopyridine HCL

Answer 28

Urinary anesthetic/analegesic- Helps with dysuria

Question 29

Disadvantage of Phenazopyridine HCL

Answer 29

Mask si/sx’s of UTI’s NOT responding to abx therapy

Question 30

What is the main SE of Phenazopyridine HCL

Answer 30

Red-orange body fluids, including soft contact lenses