UTI Case

Question 1

What makes a UTI complicated

Answer 1

male, cath/stent

Question 2

UTI clinical presentation

Answer 2

Dysuria
Urinary Frequency
Urinary Urgency
Suprapubic Pain
Hematuria
Fever/Systemic Symptoms
Flank Pain
Costovertebral Angle Tenderness
Altered Mental Status (elderly)

Question 3

When do we treat asymptomatic UTI

Answer 3

• Patient is pregnant
• Patient is undergoing urologic procedures
• Patient is neutropenic/immunocompromised

Question 4

UTI Causative Pathogens

Answer 4

1. Gram negatives (E. coli, Proteus spp., Klebsiella spp. Pseudomonas spp.)
2. Staphylococcus saprophyticus
3. Candida spp.

Question 5

First line IV UTI antibiotic

Answer 5

ceftriaxone 1g q24hr

Question 6

What oral antibiotic can be used for de-escalation

Answer 6

cefdinir
cephalexin/keflex 500mg
cefuroxime

Question 7

If the culture is ESBL, what antibiotic should you use?

Answer 7

ertapenem (meropenem covers Pseudomonas aeruginosa)

Question 8

If the culture is Pseudomonas , what antibiotic should you use?

Answer 8

ciprofloxacin