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Cecils Ch 105 UTI
Terms in this set (20)
what is a complicated UTI ?
indwelling urinary catheter, neurogenic bladder, stones, obstruction, immunosuppression, pregnancy, renal disease, or diabetes
Staph Aureus indicates
hematogenous most often in debilitated pt.
2 most common pathogens in young females
E. coli and Staph Sapro (less common)
Causes of complicated UTIs
Proteus, Pseudomonas, Klesiella , Serratia, Staph A. Entercocci
when do you treat asymptomatic bacteriuria (4) ?
urinary tract obstruction or neutropenia,
following removal of an indwelling urinary catheter
prior to an invasive urologic procedure
acute cystitis is helped by
cranberry juice , possibly
2 or more postcoital UTIs or recurrent bacteruria in pregnant do what ?
When do you screen for a/sx bacteruria ?
TURP, biopsy, tissue trauma, pregnant
STI vs. UTI in the context of onset
UTI is more abrupt than and STI
dysuria and urinary frequency without disharge think
fever, chills, sweats, nausea, vomiting, diarrhea, myalgia, and flank or abdominal pain;
rapid onset of fever, chills, low back and perineal pain, urinary frequency and urgency, nocturia, dysuria, and generalized malaise
need a UA for acute cystitis in a health women with no complicating factors ?
nonpregnant women with uncomplicated cystitis empirically with
TMP/SMZ 3days ; if resistant sub. nitrofurantoin, B lactam or quinolone
complicated UTI rx
7-14 d of fluoroquinolone or TMP/SMZ if susceptible
3-7 days with amoxicillin or nitrofurantoin if pyelonephritis --> gentamicin (lesser of two evils when compared with fluoroquinolones) ?
fluoroquinolones because they achieve higher concentrations in the urine
pyelonephritis with a persistant fever and u/l flank plain start to think about
perinephric or intrarenal abscess
acute prostatits Rx length
4-6 weeks if no response in 72 hours have TRUS or CT
does not require treatment.
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