- UTI in the Spine Injured Patient
Management:
- 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.
Bacteriuria in the catheterized patient. What quantitative level of bacteriuria is relevant?