UTI therapeutics Flashcards Preview

PT2 ID 1-6 > UTI therapeutics > Flashcards

Flashcards in UTI therapeutics Deck (61)
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1

Cystitis

-lower UTI (bladder, urethra, urine)

2

classic triad of symptoms in cystitis

dysuria
frequency
urgency

3

pyelonephritis

-upper UTI (kidneys, ureters)

4

physical symptoms of pyelonephritis

-may included classic triad
-fever
-flank pain
-CVA tenderness

5

lab indicators of pyelonephritis

-urinalysis showing >10 WBC/hpf
-urine culture showing >100,000 cfu/mL
-leukocytosis

6

uncomplicated urinary infection

-always female
-no anatomical or neurological impairments
-treated with oral therapy

7

complicated urinary infection

-all males, selected females
-anatomical/neurologic impairments present
-treat with IV or oral therapy

8

bacteria that cause uncomplicated UTI

-E.coli 75-95%
-S.saprophyticus 5-20%
-other Gm- 5-10%
-enterococcus 5-10%

9

bacteria that cause complicated UTI

-<50% E.coli
->50% other GNB; staph and E.faecalis are common

10

risk factors for UTI

-female anatomy (short urethra)
-sexual activity
-diaphragms and spermicidal agents
-menopause
-urinary tract anomolies
-obstruction of urinary tract
-suppressed immune system
-catheter use

11

most common bacteria in community acquired UTI

E.coli
Proteus
Entercoccus

12

most common bacteria in sexually active female

-staph.saprophyticus
-E.coli
-Proteus
-Enterococcus

13

most common bacteria in nursing home or hospital acquired UTI

-E.coli
-Proteus
-Entercoccus
-other GNB
-Staph

14

elements of urinalysis

-specific gravity
-protein
-glucose
-ketones
-bilirubin
-RBC
-WBC
-bacteria
-casts
-nitrite

15

why nitrites are looked at in urine

bacteria reduce nitrate to nitrite

16

when to do a urinalysis

if they are symptomatic of UTI

17

When are urine cultures done

-usually not after 1st UTI

18

specific populations that we do urine culture for

-pregnant females
-elderly patients
-diabetic pts
-immunosuppressed pts.
-males
-recurrent UTI
-catheter
-upper tract infection

19

when are blood cultures done

if the following are present
-fevers
-hypotension
-N/V
-upper tract infection
-recurrent urinary infection
-diabetics

20

what do we do if patient has positive urinalysis, but asymptomatic

do not treat

21

patients we treat when no symptoms are present but positive urinalysis

-pregnancy
-children w/ risk factors
-neutropenic patients
-post renal transplant patients
-patients undergoing urologic procedure

22

3 day therapy for uncomplicated UTI

-usually done
-TMP/SMZ
-cephalexin
-cefuroxime

23

5 day therapy for uncomplicated UTI

-nitrofurantoin
-TMP/SMZ
-various Cephs

24

standard empiric choice for cystitis

TMP/SMZ
unless resistance in area is >20%

25

back up option for acute uncomplicated UTI

quinolone for 3-5 days after other options are exhausted

26

collateral damage

-killing bacteria that were not involved in the UTI
-leads to resistances of other potentially infectious bacteria

27

collateral damage led to the emergence of what baterial strains

-VRE
-KPC pathogens
-clostridium defficile
-resistant Acinetobacter
-SPACE pathogens

28

TMP/SMZ cystitis dosing

1 tab q12h for 3 days

29

cephalexin cystitis dosing

500 mg q6h for 7 days

30

cefdinir cystitis dosing

300 mg q12h for 3-7 days