This document provides an overview of urinary tract infections (UTIs). It defines UTIs and lists the parts of the urinary tract. The pathophysiology and most common causes are described. Risk factors, signs and symptoms, diagnosis, and management approaches are outlined for both uncomplicated and complicated UTIs in different populations like children, adults, pregnant women. Imaging tests and their appropriate uses are also summarized. Treatment options for UTIs in various groups are provided.
Urinary tract infection- a detailed medical study martinshaji
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An infection in any part of the urinary system, the kidneys, bladder or urethra.
Urinary tract infections are more common in women. They usually occur in the bladder or urethra, but more serious infections involve the kidney.
A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine.
this study details all about UTI
please comment
thank you
Symptomatic presence of micro-organisms within the urinary tract i.e., kidney, ureters, bladder and urethra.
• Associated with inflammation of urinary tract.
Urinary tract infection- a detailed medical study martinshaji
HAPPY PHARMACIST DAY
An infection in any part of the urinary system, the kidneys, bladder or urethra.
Urinary tract infections are more common in women. They usually occur in the bladder or urethra, but more serious infections involve the kidney.
A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine.
this study details all about UTI
please comment
thank you
Symptomatic presence of micro-organisms within the urinary tract i.e., kidney, ureters, bladder and urethra.
• Associated with inflammation of urinary tract.
A urinary tract infection (or UTI) is caused by a bacterial infection in the urinary tract. The urinary tract is the body's drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra.
Normally, bacteria that enter the urinary tract are quickly removed by the body before they cause symptoms. But sometimes bacteria overcome the body’s natural defenses and cause infection, thus leading to a UTI.
Urinary Tract Infections are the 2nd most popular type of infection in the body. Women are especially prone to UTIs for anatomical reasons. *One factor is that a woman’s urethra is shorter, allowing bacteria quicker access to the bladder. Also, a woman’s urethral opening is near sources of bacteria from the anus and vagina. For women, the lifetime risk of having a UTI is greater than 50 percent.
Module: Pharmacology and Therapeutics III, (Therapeutics part)
Coordinator: Dr. Arwa M. Amin Mostafa
Academic Level: Undergraduate, B.Pharmacy
School: Dubai Pharmacy College
Year of first presented in Class: 2018
This presentation is for Educational purpose. It has no commercial value associated with it.
a presentation about UTI. information from various textbooks and different journals and also from many peoples presentation is accumulated in this one file. i worked very hard for this project.
A Microbiology topic on Urinary Tract Infection, covering various subtopics like the causative organism, clinical features and more importantly, the lab diagnosis.
Reference: Textbook of Medical Microbiology, Ananthnarayan & Paniker
A urinary tract infection (or UTI) is caused by a bacterial infection in the urinary tract. The urinary tract is the body's drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra.
Normally, bacteria that enter the urinary tract are quickly removed by the body before they cause symptoms. But sometimes bacteria overcome the body’s natural defenses and cause infection, thus leading to a UTI.
Urinary Tract Infections are the 2nd most popular type of infection in the body. Women are especially prone to UTIs for anatomical reasons. *One factor is that a woman’s urethra is shorter, allowing bacteria quicker access to the bladder. Also, a woman’s urethral opening is near sources of bacteria from the anus and vagina. For women, the lifetime risk of having a UTI is greater than 50 percent.
Module: Pharmacology and Therapeutics III, (Therapeutics part)
Coordinator: Dr. Arwa M. Amin Mostafa
Academic Level: Undergraduate, B.Pharmacy
School: Dubai Pharmacy College
Year of first presented in Class: 2018
This presentation is for Educational purpose. It has no commercial value associated with it.
a presentation about UTI. information from various textbooks and different journals and also from many peoples presentation is accumulated in this one file. i worked very hard for this project.
A Microbiology topic on Urinary Tract Infection, covering various subtopics like the causative organism, clinical features and more importantly, the lab diagnosis.
Reference: Textbook of Medical Microbiology, Ananthnarayan & Paniker
Urinary Tract Infection with Nursing ManagementSwatilekha Das
Urinary Tract Infection introduction, definition, common microorganisms, classification, predisposing factors, clinical manifestations, pathophysiology, diagnostic studies, medical management and nursing management along with assessment, nursing diagnosis, goal, nursing interventions and expected outcome after the intervention.
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easy description of common lut disorders. improvements on the slides accepted. text includes congenital and acquired disorders. more so the causes of bladder outlet obstructions. also management of the disorders are breifly described.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
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- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. Objectives
By the end of this presentation the participants will be able to:
◦ list lower and upper urinary tract parts.
◦ Define urinary tract infection.
◦ Explain the pathophysiology of urinary tract infection
◦ List the most risk factors for urinary tract infection
◦ Diagnose urinary tract infection
◦ Manage urinary tract infection in different sex and age
category.
3. Introduction
A urinary tract infection (UTI) is an infection in any part of
your urinary system — your kidneys, ureters, bladder and
urethra. Most infections involve the lower urinary tract —
the bladder and the urethra.
Women are at greater risk of developing a UTI than are
men. Among adults aged 20 to 50 years, UTIs are about 50-
fold more common in women.
4. In women in this age group, most UTIs are cystitis or
pyelonephritis.
In men of the same age, most UTIs are urethritis or
prostatitis.
The incidence of UTI increases in patients > 50 years, but
the female: male ratio decreases because of the increasing
frequency of prostate enlargement and instrumentation in
men.
Introduction
10. Etiology
The bacteria that most often cause cystitis and pyelonephritis are the following:
Enteric, usually gram-negative aerobic bacteria (most often)
Escherichia coli : 75 to 95% of cases.
Klebsiella
Proteus mirabilis
Pseudomonas aeruginosa.
Gram-positive bacteria (less often)
Staphylococcus saprophyticus is isolated in 5 to 10% of bacterial UTIs.
Enterococcus faecalis (group D streptococci)
Streptococcus agalactiae (group B streptococci)
In hospitalized patients, E. coli accounts for about 50% of cases. The gram-negative species Klebsiella, Proteus,
Enterobacter, Pseudomonas, and Serratia account for about 40%, and the gram-positive bacterial cocci, E.
faecalis, S. saprophyticus, and Staphylococcus aureus account for the remainder.
11.
12. Part of urinary tract affected Signs and symptoms
Kidneys (acute pyelonephritis)
•Upper back and side (flank) pain
•High fever
•Shaking and chills
•Nausea
•Vomiting
Bladder (cystitis)
•Pelvic pressure
•Lower abdomen discomfort
•Frequent, painful urination
•Blood in urine
Urethra (urethritis)
•Burning with urination
•Discharge
13. Uncomplicated UTI is usually considered to be
cystitis or pyelonephritis that occurs in
premenopausal adult women with no structural or
functional abnormality of the urinary tract and who
are not pregnant and have no significant
comorbidity that could lead to more serious
outcomes.
14. Complicated UTI can involve either sex at any age. A
UTI is considered complicated if:
1. the patient is a child, is pregnant,
2. the patient has any of the following:
◦ A structural or functional urinary tract abnormality and obstruction
of urine flow
◦ A comorbidity that increases risk of acquiring infection or resistance
to treatment, such as poorly controlled diabetes, chronic kidney
disease, or immunocompromise.
◦ Recent instrumentation or surgery of the urinary tract
15. Complication
Recurrent infections, especially in women who experience two or more
UTIs in a six-month period or four or more within a year.
Permanent kidney damage from an acute or chronic kidney infection
(pyelonephritis) due to an untreated UTI.
Increased risk in pregnant women of delivering low birth weight or
premature infants.
Urethral narrowing (stricture) in men from recurrent urethritis, previously
seen with gonococcal urethritis.
Sepsis, a potentially life-threatening complication of an infection,
especially if the infection works its way up your urinary tract to your
kidneys.
17. Urine collection
clean-catch, midstream specimen,
A specimen obtained by catheterization
If a sexually transmitted disease (STD) is suspected, a
urethral swab for STD testing is obtained prior to
voiding.
18. Urine testing:
Dipstick tests:
tested rapidly
Nitrate positive: is highly specific for UTI, but the test is not very sensitive.
The leukocyte esterase test is very specific for the presence of > 10 WBCs/μL and is fairly
sensitive.
Microscopic examination:
Pyuria : Most truly infected patients have > 10 WBCs/μL.
The presence of bacteria in the absence of pyuria:due to contamination during sampling.
Microscopic hematuria occurs in up to 50% of patients, but gross hematuria is uncommon.
WBC casts: pyelonephritis, glomerulonephritis, and noninfective tubulointerstitial nephritis.
Pyuria in the absence of bacteriuria and of UTI is possible, for example, if patients have
nephrolithiasis, a uroepithelial tumor, appendicitis, or inflammatory bowel disease or if the
sample is contaminated by vaginal WBCs.
19. Cultures are recommended in complicated UTI or an indication for
treatment of bacteriuria. Common examples include the following:
Pregnant women
Postmenopausal women
Men
Prepubertal children
Patients with urinary tract abnormalities or recent
instrumentation
Patients with immunosuppression or significant
comorbidities
Patients whose symptoms suggest pyelonephritis or sepsis
Patients with recurrent UTIs (≥ 3/yr)
20. Urinary tract imaging choices include ultrasonography, CT, and IVU.
Occasionally, voiding cystourethrography, retrograde urethrography, or
cystoscopy is warranted.
Children with UTI often require imaging.
Most adults do not require assessment for structural abnormalities
unless the following occur:
The patient has ≥ 2 episodes of pyelonephritis.
Infections are complicated.
Nephrolithiasis is suspected.
There is painless gross hematuria or new renal insufficiency.
Fever persists for ≥ 72 h.
21. KUB ultrasound
First-line, non-invasive imaging
MCUG
Contrast radiographic imaging
Nuclear scans DMSA and MAG3Radioisotope nuclear
imaging
Uses
Assess
•Fluid collections
•Bladder volume
•Kidney: size, shape, location
•Urinary tract: obstructions, dilatations
Confirm
•Posterior urethral valves
•Obstructive Uropathies
•Gold standard for VUR diagnosis
Confirm
Suspicion of renal damage
DMSA: Gold standard for renal scar detection
MAG3:
•Faster, less radiation
•Renal excretion enables micturition study
Indications
•Concurrent bacteraemia
•Atypical UTI organisms
• Staphylococcus aureus
• Pseudomonas
•UTI <3 years old
•Non/inadequate response to 48hrs of IV antibiotics
•Abdominal mass
•Abnormal voiding
•Recurrent UTI
•First febrile UTI and no prompt follow up assured
•Renal impairment
•Significant electrolyte derangement
•No antenatal renal tract imaging in second to third
trimester
•Abnormal renal ultrasound
• Hydronephrosis
• Thick bladder wall
• Renal scarring
•Abnormal voiding post-febrile UTI
•Post-second febrile UTI
•Suspicion of
• VUR
• posterior urethral valves
•Clinical suspicion of renal injury
•Reduced renal function
•Suspicion of VUR
•Suspicion of obstructive uropathy on ultrasound in
older toilet-trained children
Limitations
•Does not asses function
•Operator dependent
•Cannot diagnose VUR
•Radiation exposure ~1 mSv
•Invasive
•Unpleasant to perform post-infancy
•May require sedation
•Requires prophylactic antibiotics
•Dynamic renal excretion study requires toilet training
•False positives if <3 months post-UTI, therefore can’t
use in acute phase (0–4 weeks)
•May require sedation
•Cannot determine old versus new scarring
22. Differential Diagnosis
Acute urethral syndrome: which occurs in women, is a syndrome involving dysuria, frequency, and
pyuria (dysuria-pyuria syndrome), which thus resembles cystitis. However, in acute urethral syndrome
(unlike in cystitis), routine urine cultures are either negative
Urethritis: is a possible cause because causative organisms include Chlamydia trachomatis and
Ureaplasma urealyticum, which are not detected on routine urine culture.
Noninfectious causes:
anatomic abnormalities (eg, urethral stenosis),
physiologic abnormalities (eg, pelvic floor muscle dysfunction),
hormonal imbalances (eg, atrophic urethritis),
localized trauma,
GI system symptoms, and inflammation.
23. Management
Urethritis
Sexually active patients with symptoms are usually treated presumptively for
STDs pending test results. A typical regimen is ceftriaxone 250 mg IM plus either
azithromycin 1 g po once or doxycycline 100 mg po bid for 7 days.
Cystitis
First-line treatment of uncomplicated cystitis is nitrofurantoin 100 mg po bid for
3 days (it is contraindicated if creatinine clearance is < 60 mL/min),
trimethoprim/sulfamethoxazole (TMP/SMX) 160/800 mg po bid for 3 days,
24. Management
Acute pyelonephritis
Antibiotics are required. Outpatient treatment with oral antibiotics is possible if all of the
following criteria are satisfied:
Patients are expected to be adherent
Patients are immunocompetent
Patients have no nausea or vomiting or evidence of volume depletion or septicemia
Patients have no factors suggesting complicated UTI
Ciprofloxacin 500 mg po bid for 7 days
A 2nd option is usually trimethoprim/sulfamethoxazole (TMP/SMX) 160/800 mg po bid for 14
days.
30. Non-pregnant Women
Consider empirical treatment with an antibiotic for
otherwise healthy women aged less than 65 years
presenting with severe or ≥ 3 symptoms of UTI.
Explore alternative diagnoses and consider pelvic
examination for women with symptoms of vaginal itch or
discharge.
Use dipstick tests to guide treatment decisions in otherwise
healthy women under 65 years of age presenting with mild
or ≤2 symptoms of UTI.
31. Antibiotic treatment of LUTI
Do not treat non-pregnant women (of any age) with
asymptomatic bacteriuria with an antibiotic.
Treat non-pregnant women of any age with symptoms or signs
of acute LUTI with a three day course of trimethoprim or
nitrofurantoin.
Particular care should be taken when prescribing nitrofurantoin
in the elderly, who may be at increased risk of toxicity.
Take urine for culture to guide change of antibiotic for patients
who do not respond to trimethoprim or nitrofurantoin.
32. Pregnant Women
Symptomatic bacteriuria
Standard quantitative urine culture should be performed routinely at
first antenatal visit.
Confirm the presence of bacteriuria in urine with a second urine
culture.
Do not use dipstick testing to screen for bacterial UTI at the first or
subsequent antenatal visits.
Treat asymptomatic bacteruria in pregnant women with antibiotics
33. Pregnant Women
Antibiotic treatment
Treat symptomatic UTI in pregnant women with an antibiotic.
Take a single urine sample for culture before empiric antibiotic
treatment is started.
A seven day course of treatment (amoxicillin – cephalexin-
augmentin)is normally sufficient.
Given the risks of symptomatic bacteriuria in pregnancy, a urine
culture should be performed seven days after completion of
antibiotic treatment as a test of cure.
34. Men
Urinary tract infections in men are generally viewed as complicated because they result from an
anatomic or functional anomaly or instrumentation of the genitourinary tract.
Conditions like prostatitis, chlamydial infection and epididymitis should be considered in the
differential diagnosis of men with acute dysuria or frequency and appropriate diagnostic tests should
be considered.
In all men with symptoms of UTI a urine sample should be taken for culture.
Antibiotic treatment
Due to their ability to penetrate prostatic fluid, quinolones (ciprofloxacillin) rather than nitrofurantoin
or cephalosporins are indicated.
Treat bacterial UTI empirically with a quinolone in men with symptoms suggestive of prostatitis.
four week course is appropriate for men with symptoms suggestive of prostatitis.
Refer men for urological investigation if they have symptoms of upper urinary tract infection, fail to
respond to appropriate antibiotics or have recurrent UTI.
35. Patients On Catheter
Do not rely on classical clinical symptoms or signs for predicting the
likelihood of symptomatic UTI in catheterised patients.
Signs and symptoms compatible with catheter-associated UTI
include:
◦ new onset or worsening of fever, rigors
◦ altered mental status, malaise, or lethargy
◦ flank pain or costovertebral angle tenderness
◦ acute haematuria
36. Patients On Catheter
Do not use dipstick testing to diagnose UTI in patients with
catheters.
Antibiotic treatment
Do not treat catheterised patients with asymptomatic
bacteriuria with an antibiotic.
Do not routinely prescribe antibiotic prophylaxis to prevent
symptomatic UTI in patients with catheters.
37. Prevention
Drink plenty of liquids, especially water.
Drink cranberry juice.
Wipe from front to back.
Empty your bladder soon after intercourse.
Avoid potentially irritating feminine products.
Change your birth control method.
38. In women who experience ≥ 3 UTIs/yr, behavioral measures are
recommended, If these techniques are unsuccessful, antibiotic
prophylaxis should be considered. Common options are continuous
and postcoital prophylaxis.
Continuous prophylaxis commonly begins with a 6 mo trial. If UTI
recurs after 6 mo of prophylactic therapy, prophylaxis may be
reinstituted for 2 or 3 yr.
TMP/SMX 40/200 mg po once/day or 3 times/wk,
nitrofurantoin 50 or 100 mg po once/day, cephalexin 125 to 250 mg
po once/day,
Prevention
39. Postcoital prophylaxis in women may be more effective if
UTIs are temporally related to sexual intercourse. Usually, a
single dose of one of the drugs used for continuous
prophylaxis is effective.
In postmenopausal women, antibiotic prophylaxis is similar
to that described previously. Additionally, topical estrogen
therapy markedly reduces the incidence of recurrent UTI in
women with atrophic vaginitis or atrophic urethritis.
Prevention
40. summary
Refer infant less than 3 months with UTI
Treat children 3 months and older with UTI using Amoxicillin/ Augmnetin, send
culture and consider request for ultrasound
Treat non-pregnant women with 3 days Nitrofurantoin
Treat asymptomatic bacteruria in pregnant women
Consider STI and prostitis in male
Do not give prophylaxis for adult with catheter and do not treat asymptomatic
bacteruria
41. Case 1
1 month-old boy presented with fever of one day duration. He has
no associated symptoms. The child is stable but look irritable. Vitals
normal apart from temperature 38.5. systemic examination is
unremarkable. What is your management ?
A. Ask for urine sample
B. Prescribe Antibiotics
C. Prescribe Paracetamol
D. Refer for admission
43. Case 2
5 year-old girl presents with abdominal pain and fever for
the last 2 days. You want o role out urinary tract infection in
this girl. Which one is the most suitable test for this
purpose?
A. Urine dipstick
B. Urine microscopy
C. Urine culture
What is the positive test finding ?
45. Case 3
25 year-old pregnant lady. She is 10 weeks gestation. She presents
for booking visit. You reviewed her booking investigations. They are
normal apart from bacteruria. Patient has no symptoms suggestive
of urinary tract infection. What is management?
A. Reassure and advice her to increase fluid intake
B. Repeat urine microscopy for confirmation
C. Send for urine culture and manage accordingly
D. Send urine culture and start antibiotics
47. Case 4
20 year-old male present with dysuria of two days duration. He has
no fever or abdominal pain. Urine microscopy shows:
WBC 20 , RBC 4. What is most appropriate management:
A. Do sexual transmitted infection screening
B. Request for ultrasound
C. Send for urine culture for sensitivity and Start antibiotics
D. Start antibiotics and repeat urine microcopy after one week
49. Case 5
28 year-old non-pregnant women presents with dysuria and lower
abdominal pain for the last 3 days. Urine microscopy shows: WBC 40,
RBS: 2 . what the is the best antibiotics for this patiatent:
A. Amoxicillin 500 mg tid 3 days
B. Augmentin 275/125 tid 7days
C. Ceftriaxone 125 mg iv single dose
D. Nitrofurantoin 100 mg bid 3 days