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Therapeutics - UTI 2
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How old should a patient be to take Cipro or Levo for UTI?
>16 years
What is the dose of Nitrofurantoin macrocrystals for a short course treatment of UTI?
100 mg PO BID x 5 days
What CrCl is required of a patient receiving Nitrofurantoin macrocrystals for UTI?
>50 (some say 60)
What are the indications for a 7-14 day UTI therapy?
Men > 40 years
Pre-existing renal disease
Pregnancy
Re-infection or resistant infection
Children not indicated for 3 day therapy
What are the DOC for a 7-14 UTI antibiotic therapy?
TMP/SMX
Amoxicillin/clavulanate or Amoxacillin
Nitrofurantoin microcrystals
TMP/SMX would be a poor choice for what group of patients when treating UTI?
Pregnancy 1st trimester (teratogen)
Pregnancy last trimester (causes hyperbillirubinea in the infant)
What is the dose indicated for a 7-14 day treatment with Amoxacillin/clavulanate for UTI?
875 mg PO BID
What is the dose indicated for a 7-14 day treatment with Amoxacillin for UTI?
500 mg PO TID
What group of patients should not receive Nirofurantoin macrocrystals for UTI?
Pregnancy last trimester (causes hyperbillirubinea in the infant)
CrCl <50 (or some say 60)
What is the dose of Nitrofurantoin macrocrystals for a 7-14 day treatment of UTIs?
100 mg PO BID
What are the supportive therapies for UTI?
Fluids
Urinary analgesics
Antipyretics
What is the urinary analgesic usually used for UTI?
Phenazopyridine
When should you treat asymptomatic bacteruria?
When pregnant or a child
What is the minimum treatment length for pyelonephritis?
10-14 days
What antibiotics are used for outpatient treatment of Pyelonephritis?
TMP/SMX
Cipro
What is the dose of Cipro for the treatment of pyelonephritis?
250-500 mg PO BID
What are the indications for inpatient treatment of pyelonephritis?
Unable to tolerate oral meds
Dehydration/Hypotension
Pediatric/elderly
Immunocomprimised
Pregnant
What drugs are given for inpatient therapy for pyelonephritis?
Cipro
Ceftriaxone
Piperacillin/tazobactam
Aztreonam
Aminoglycosides (gentamicin or tobramycin)
Ampicillin
What is the dose of ciprofloxacin for the inpatient treatment of pyelonephritis?
200-400 mg IV Q12H x 10-14 days
What is the dose of ceftriaxone for the inpatient treatment of pyelonephritis?
1 gram IV Q24H x 10-14 days
What is the dose of piperacillin/tazobactam for the inpatient treatment of Pyelonephritis?
3.375 gm IV Q12H x 10-14 days
What group is piperacillin/tazobactam particularly good for when treating inpatients for pyelonephritis?
Nursing home or hospital acquired patients, which have a higher pseudomonas risk
How long should you treat a patient with pyelonephritis for?
10-14 days
What is the dose for gentamicin or tobramycin for the treatment of pyelonephritis?
3-5 mg/kg/day divided in multiple daily doses
Or
7mg/kg/24 hours QD
What is the dose for Ampicillin for inpatient treatment of pyelonephritis?
12 grams IV Q6H
When should you stitch an inpatient from IV to PO when treating pyelonephritis?
Absence of fever for 24 hours
Able to tolerate PO medications
How are recurrent pyelonephritis infections treated?
Usually by adding 7 days onto the treatment
Should be cultured to make sure the drug is adequate
When should a patient receive prophylactic therapy for pyelonephritis?
> or = to 3 infections per year
How do you treat a patient with > or = to 3 pyelonephritis infections per year and is related to intercourse?
TMP/SMX 1 tab
Nitrofurantoin 50-100 mg
Cephalexin 250 mg
Empty bladder and take after intercourse
How do you treat a patient with > or = to 3 pyelonephritis infections per year that is not related to intercourse?
TMP/SMX 0.5 tabs HS or 3x/week
Nitrofurantoin 50-100 mg HS
Norfloxacin 200 mg HS
Cephalexin 250 mg HS
What should you counsel a patient on when they are receiving medications for UTI?
Expected outcome
Antibiotic information
Importance of compliance
How to prevent future occurrence
Author
kyleannkelsey
ID
285841
Card Set
Therapeutics - UTI 2
Description
Therapeutics - UTI
Updated
2014-10-14T22:54:44Z
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