Urinary Tract Infections / Prostatitis (4) Pharmacotherapy

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Final Exam Prep
Sam Adeyiga
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Sam Adeyiga
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Define Asymptomatic bacteriuria (ASB) patient has no urinary symptoms, but 2 consecutive urine cultures show > 105 (100,000) bacteriaCFUs/mL of urine with the same microorganism
Trt of Asymptomatic bacteriuria (ASB) is recommended in -------- 1. children or pregnant females 2. in other adults, treatment is only recommended prior to an invasive urological procedure (to prevent introduction of bacteria).
What kind of UTI infection is Candiduria? 1. Fungal UTI: yeast 2. is a yeast in the urinary tract
Define re-Infection (80%) 1. a UTI caused by a completely new infection 2. typically occurs > 2 weeks after the completion of therapy for a previous UTI.
Re-infection: trt for a pt w/ < 3 infections per year include each episode shd be treated as a separately occurring infection, usually with a short course of antibiotic therapy.
Re-infection: trt for a pt w/ > 3 infections per year include 1. identify RF like Sex, if yes = void after intercourse, take a SMX/TMP (400/80 mg) single strength tablet after each sex 2. prophylactic therapy daily for 6 months.
Oral prophylactic therapy for Re infection include 1. one-half SMX/TMP SS tablet 2. trimethoprim 100 mg 3. nitrofurantoin 50 - 100 mg 4. Levofloxacin 500 mg PO daily can also be used as prophylaxis = beware of "collateral damage"
Define relapse (20%) 1. a UTI caused by the same pathogen that didn’t have complete eradication. 2. typically occurs WITHIN 2 weeks of completion of antibiotic therapy for a previous UTI.
If a patient relapses after short-course therapy, treatment should be given with a different agent for 2 weeks [T or F] True
For relapse, If the patient previously received 2 weeks of therapy, treatment should be extended to -------- weeks 4 weeks
Patients who previously received 4 to 6 weeks of treatment may need a ---------- evaluation to correct any obstruction. In males who relapse, ---------- should be considered 1. urologic 2. prostatitis
TRUE OR FALSE: Bacteriuria is common and DOES NOT typically warrant antibiotic therapy in Catheterized patients (even if there are > 100,000 CFUs bacteria/mL). True
True or False: UA and cultures are usually not performed in patients with a catheter because it is almost always positive. True
For symptomatic Catheter-Associated UTI (CAUTI), treatment do ---------- ? 1. a catheter change plus 2. a 7-14 day course of antibiotic therapy
Catheterized patients w/ prompt resolution of symptoms (i.e. w/n 48 hrs) shd have antibodies for --------? 7 days
Catheterized patients w/ delayed resolution of symptoms shd have antibodies for --------? 14 days
catheterized patients are also at higher risk of MDROs including (1)--------------, (2) -----------------? 1. Staphylococcus aureus 2. Candida albicans
True or False: A UTI in a pregnant female is considered uncomplicated in most cases True
For pregnancy, (1) ------------- and (2) ----------- are safe to use in all trimesters of pregnancy 1. Amoxicillin/clavulanate 2. cephalosporins
Avoid ------------- in late pregnancy (38-42 weeks) nitrofurantoin
---------------- has increased fetal risks Sulfamethoxazole/trimethoprim
categories of prostatitis include 1. Acute bacterial prostatitis 2. chronic bacterial prostatitis 3. chronic abacterial prostatitis 4. granulomatous prostatitis
Acute and chronic bacterial prostatitis are caused by these pathogens ----------- [KEEPP] 1. result from aerobic, Gram-negative rods. 2. E. coli 3. Klebsiella 4. Proteus 5. Enterococcus spp 6. Pseudomonas
Acute bacterial prostatitis as a result of urine from the posterior urethra or from the urinary bladder, but can also occur as a result of hematogenous spread from a distant site, or from surgical manipulation of the urethra or prostate gland itself
Chronic abacterial prostatitis 1. lacks the history of recurrent urinary tract infections 2. lacks a positive bacterial culture from prostatic secretions.
Granulomatous prostatitis can be caused by 1. a fungal source (fungal granulomatous prostatitis) that is typically only seen in immunocompromised patients, or by treatment of bladder cancer.
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