chapter 47 UTI

Question 1

drug therapy

Answer 1

• need gram negative coverage
• tmp/smx first line drug with no complication
• alternative/second line: amoxicillin or cephalosporins
• length of tx 3 days-longer in children, fever, chills, pregnancy, hx of DM or immunosupressed

Question 2

tx for specialty groups

Answer 2

infants/children: febrile UTI treated aggressively with parenteral abx until afebrile

• tx for 10 days
  elderly: risk for asymptomatic UTI, tx based on c&s
  males: increased risk for enlarged prostate
  pregnant: asymptomatic bacteriuria, routine screening

Question 3

pathophysiology

Answer 3

host factors: pt. with repeated UTI have altered bladder epithelial cells that helps bacteria adhere to mucosa;
-women and girls have shorter urethra
-incomplete bladder emptying
-pregnancy
behavioral facts: sexually active, resisting urge to void
pathogen: e.coli attaches to mucosa