Management of Bacterial UTI'

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Management of Bacterial UTI.

• Hot Topic Oct 06
• EA Doherty

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• Mx in adult female
• Mx in pregnancy
• Mx in adult male

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Signs and symptoms

• Dysuria
• Frequency
• Polyuria
• Fever
• Flank pain
• Suprapubic pain

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Adult Female

• Signs and Symptoms of UTI
• Multiple symptoms
• Trimethoprim or Nitrofurantoin for 3/7-no
  improvement-culture
• Fever/back pain consider UUTI
• Limited symlt2 Dipstick ve
• Dipstick -ve Offer Abx
• Vaginal itch

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UUTI

• Signs and symptoms
• ? Systemic symptoms
• No-Ciprofloxacin for 7/7 and urine culture. No
  response
• Yes-admit

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Pregnancy

• Symptomatic
• Obtain urine culture
• Treat with Antibiotic
• Recheck urine 7/7 after completion of course

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• Trimethoprim not in 1st trimester
• Sulphonamides-haemolysis
• Tetracycline-skeletal abn
• Quinolones
• Nitrofurantoin-neonatal haemolysis

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Screening for assym bacteruria

• 1st antenatal visit-urine culture
• Not dipstick
• Culture ve -confirm and treat
• Repeat urine culture at each antenatal visit
• Culture -ve not for rpt cultures

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Men and UTIs

• Sym and signs
• DDx
• All men take a urine culture
• Rx 2/52 with a quinolone
• Fever/Back pain UUTI-2/52 of quinolone
• Recurrent Refer for Ix

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Children

• Clean catch or MSSU
• lt2 years
• Renal USS
• MCUG-6/52
• 2-7
• DMSA after 3/12

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