Abx for STD/UTI?

Whenever I get a UTI, they give me Bactrim. Except once, when they gave me cephalexin.

 

I hear cranberry juice works great... just mix in a little Vodka and you're killing two birds with one drink (bacteria + hepatocytes)

 

I'm too tired to be completely sure, but I think TMP-SMX is always a safe bet. I could have sworn I've seen amoxicillin thrown around here and there, but forget that one...as my colleague said, bactrim is 1st line for UTIs.

 

TMP-SMX works well in most UTI's, but be careful that they don't have a sulfa drug allergy. For pregnant women, I would recommend ampicillin/sulbactam. C. trachomatis give them azithromycin or ciprofloxacin. N. gonnorrhea - "Tri to Fix a Fox" Basically ceftriaxone, cefixime, cofoxitin.

I'm too lazy to list the rest.

 

I think knowing ceftriaxone for gonnorrhea + 1 dose azithro (or a course of doxy) for chlamydia is important. I must have been asked this 20 times. Ditto on bactrim for UTI (despite UWs crazy made up UTI drugs...)

 

+1

They're all about that one dose treatment plan for gonnorrhea and chlamydia so you don't have the patient come back to your clinic still complaining of dysuria a week later.

 

I'm in agreement with this... it's important to treat for both gonorrhea and chlamydia (cephalosporin and azithromycin) even if you don't test for both. Also, syphillis gets penicillin. As for UTIs, I usually just pick TMP/SMX unless contraindicated due to allergy. Good luck!

 

I agree with what everyone else said- gon/chlam= cephalosporin+ azith/doxy
UTI- bactrim of ciprofloxacin
Syphilis- penicillin

And a random note: if you have a pregnant woman who has syphillis and an allergy to penicillin you still give penicillin.

 

really?

 

how about nitrofurantoin for UTI in a pg patient?

 

Yeah, it's fine, it falls in the Class B pregnancy category. TMP-SMX is CONTRAINDICATED in women that are preggers though.

http://www.aafp.org/afp/20000201/713.html

 

Agree with above, but as mentioned don't forget about nitrofurantoin. Hardly ever mentioned, but it concentrates in urine and has activity pretty much only there and nowhere else, and does a great job against most bladder infections. Major toxicity is to the lung, so the patient has to be aware of early symptomatology. Gonorrhea/syphilis/chlamydia gets the usual. Amoxicillin for chlamydia in pregnancy instead of azithromycin.

Syphilis really needs penicillin, and if necessary you can do a one-time desensitization process in the case of allergy, even in pregnancy. It's not something to be taken lightly though, and shouldn't be stopped once you start.