Abx for STD/UTI?

Discussion in 'Step I' started by Cards21aceking, Jun 17, 2008.

  1. Cards21aceking

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    So, its getting near crunch time and I'm still having difficulty trying to figure out what would be appropriate treatment for either of these scenarios.

    Any thoughts?
     
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  3. LadyWolverine

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    Whenever I get a UTI, they give me Bactrim. Except once, when they gave me cephalexin.
     
  4. djnels01

    djnels01 "You're the man now dog!"
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    I hear cranberry juice works great... just mix in a little Vodka and you're killing two birds with one drink (bacteria + hepatocytes)
     
  5. MSKalltheway

    MSKalltheway I got the magic stick

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    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.
     
  6. GynGuy1983

    GynGuy1983 C&A Psychiatry Fellow

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    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.
     
  7. TerpMD

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    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...)
     
  8. GynGuy1983

    GynGuy1983 C&A Psychiatry Fellow

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    +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.
     
  9. opb

    opb

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    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!
     
  10. Instatewaiter

    Instatewaiter But... there's a troponin

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    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.
     
  11. TerpMD

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  12. ShyRem

    ShyRem I need more coffee.
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    how about nitrofurantoin for UTI in a pg patient?
     
  13. GynGuy1983

    GynGuy1983 C&A Psychiatry Fellow

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    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
     
  14. osli

    osli Senior Member

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    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.
     

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