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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) ?
pregnancy
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 ?
prophylactic Ab
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
cystitis >90%
fever, chills, sweats, nausea, vomiting, diarrhea, myalgia, and flank or abdominal pain;
Pyelonephritis
rapid onset of fever, chills, low back and perineal pain, urinary frequency and urgency, nocturia, dysuria, and generalized malaise
Acute prostatitis
need a UA for acute cystitis in a health women with no complicating factors ?
No
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
pregnant
3-7 days with amoxicillin or nitrofurantoin if pyelonephritis --> gentamicin (lesser of two evils when compared with fluoroquinolones) ?
pyelonephritis
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
asymptomatic bacteriuria
does not require treatment.
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