Second Chance Exam - UTI | Take the Quiz

Signs of fever/chills, flank pain, or vomiting are indicative of:

Cystitis

Pyelonephritis

What is a possible empiric antibiotic therapy for patients with no allergies?

Ciprofloxacin 250 mg PO Q 12 hours x 3 days

Amoxicillin 500 mg PO Q 8 hours x 7 days

Nitrofurantoin 100 mg PO Q 12 hours x 5 days

Levofloxacin 500 mg IV Q 24 hours x 3 days

What are some pro's of using nitrofurantoin? (MULTI ANSWER)

Good coverage for common gram positive and negative urinary pathogens including E. coli

No systemic absorption

Low collateral damage

Can treat pyelonephritis

What are some con's of using nitrofurantoin? (MULTI ANSWER)

Can not treat pyelonephritis

Drug can not concentrate well into the urine with CrCl < 50

Systemic absorption

High collateral damage

What are some pro's of using Bactrim? (MULTI ANSWER)

Good activity against common urinary pathogens

Able to penetrate into both lower and upper urinary tract

Low propensity for collateral damage (compared to fluoroquinolones)

No resistance

What are some con's of using Bactrim? (MULTI ANSWER)

Increasing resistance

Should not be used empirically when local resistance > 20%

Cannot penetrate into both lower and upper urinary tract

High collateral damage

What are some pro's of Fosfomycin? (MULTI ANSWER)

What are some con's of Fosfomycin? (MULTI ANSWER)

What are some pro's of FQs? (MULTIPLE ANSWER)

Able to penetrate into both lower and upper urinary tract (Ciprofloxacin and levofloxacin only)

XR formulations allow for once daily dosing

Broad spectrum of activity including common urinary pathogens

No renal dosing

Low collateral damage

What are some con's of FQs? (MULTI ANSWER)

What are some pro's for using beta-lactams? (MULTI ANSWER)

Empiric use of broad spectrum cephalosporins for pyelonephritis

Narrow spectrum cephalosporins low collateral damage

Oral cystitis option more effective than Bactrim

What are some con's for using beta-lactams? (MULTI ANSWER)

Broad spectrum cephalosporins high collateral damage

Increasing rates of ESBL producing organisms

Oral cystitis options less effective than TMP-SMX and fluoroquinolones

Cannot be used empirically

When susceptibility unknown or FQ resistance known to be >10% use:

Cephalexin

Cetriaxone 1g IV

Levofloxacin

What can be used with hx ESBL E. Coli for empiric treatment?

Vancomycin

Meropenam

Cephalexin

Levofloxacin

How long should treatment last for complicated UTI?

5 days

7 days

9 days

14 days

Second Chance Exam - UTI

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