Urinary Tract Infection Pyuria is almost always present Blood casts- represent upper infection Pos Nitrite= enterobacteriaceaeia Leukocyte esterase count of > 10/ml Presence of bacteria on UA Urine culture

Urinary Tract Infection Cystitis Bactrim= 3 days Nitrofurantoin- 5 days Quinolones- 3 days Beta lactam 3-7 days Fosphomycin 3 gm once Pylonephritis Uncomplicated - Bactrim= 14 days - Quinolones= 5-7 days - Beta lactam= days

Urinary Tract Infections Cystitis Burning upon urination - cause bacteria from vagina eg: sexual activity Pylonephritis Flank pain, fever, increased WBC, chills, N/V, - caused by seeding kidneys From the lymphatics

URINARY TRACT INFECTIONS Complicated UTI Eg: sepsis= 7 days Quinolone, aminoglycoside, b-lactam= 5-14 days Cipro= 5 days Prostatitis= 4 wks bactrim or quinolones Pregnancy Treat for 7 days.. Amoxicillin, nitrofurantoi, cephalexin. (avoid quinolones, tcn, aminoglycoside, sulfa I f possible) Epidymitis- older than 35= 10 days to 4 weeks nafcillin, add peng if youger or suspect STD

Long term Abx for UTI Bactrim.. 40mg/200mg daily or thrice weekly Trimethoprim… 100 mg q day Cipro 125 mg q day Cephalexin 125mg to 250 mg daily Nitrofurantoin – mg daily Norfloxacin… 200 mg q day Fosfomycin – 3 gm every 10 days