Urinary Tract Infection

- UTI in the Spine Injured Patient

   - Rx with ATB's, pending urine culture
   - Consider single dose therapy for symptomatic non-pregnant women with no known anatomic abnormalities;
   - Follow up culture in 7 to 14 days;
   - Prolonged therapy (7-10 days) is for symptomatic men, pregnant women or patients with symptoms of upper UTI, patients with renal disease or obstruction, and children;
   - Determine drug allergies;
       * Uncompicated UTI:
            - TMP/SMX: (160/800mg) bid PO x 3 days;
            - Augmentin;
       * Single Dose therapy:
            - Amoxicillin 3 gm PO
            - Sulfisoxazole 2 gm PO
            - septra 320/1600 mg PO
       * 7 - 14 day Therapy:
            - Sulfisoxazole 2 gm PO then 1-2 gm PO qid;
            - septra 160/800 mg PO bid;
            - Amoxicillin 250 mg PO q8hr;
            - Cephalexin 500 mg PO qid;
  * Note: the presence of bacteria in ea high power field of urine suggests the prensence of UTI the presence of > 8 WBC per HPF suggests UTI;
- acidification of the urine enhances the effect of all antimicrobials except the aminoglycocides;
   - this effect can be accomplished by ascorbic acid, ammonium chloride, cranberry or grape juice;
- See: Methenamine Hippurate/Hiprex

Management of urinary tract infections in adults.

Urinary tract infection in oliguric patients with chronic renal failure.

A comparison of the urological complications associated with long-term management of quadriplegics with and without chronic indwelling urinary catheters.

Bacteriuria in the catheterized patient. What quantitative level of bacteriuria is relevant?

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, December 11, 2012 11:42 am