Step I UTI Treatment

[chromuffin]

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What is the typical treatment plan for UTIs? Here's what I know:

Nitrofurantoin if uncomplicated

TMP-SMX if complicated

But what if the patient has a sulfa allergy? What if TMP-SMX doesn't work?

Aminoglycosides or fluoroquinolones first?
Sorry this is a pretty obvious question but I just suck at pharm

 

[cellsaver]

What is the typical treatment plan for UTIs? Here's what I know:

Nitrofurantoin if uncomplicated

TMP-SMX if complicated

But what if the patient has a sulfa allergy? What if TMP-SMX doesn't work?

Aminoglycosides or fluoroquinolones first?
Sorry this is a pretty obvious question but I just suck at pharm

Pharma is not your problem

 

[chromuffin]

Pharma is not your problem

Short-term recall. I miss 25% of my questions from pharm on practice nbmes

 

[iBS1972]

I deleted my original post, because I gave the recommendations for community-acquired pneumonia, rather than UTIs. But decided to post it anyways, considering that you're confused about UTI treatment, so it's likely that treatment guidelines for CA-P would be helpful for you as well. If not, then hopefully it'll help others.

outpatient
healthy: doxycycline or macrolide
comorbidities: fluoroquinolone, OR beta-lactam + macrolide

inpatient
(non-ICU)
fluoroquinolone, OR
beta-lactam + macrolid

inpatient (ICU)
beta-lactam + macrolide (IV), OR
beta-lactam + fluoroquinolone

This is per Uworld Step 2CK

 

[faisal 2000]

according to my family medicine lectures
tx of complicated UTI is fluoroquinolones (levofloxacin, ciprofloxacin)

 

[iBS1972]

Something good to know is the distinction between uncomplicated vs. complicated UTI:
-- Male
-- child
-- advanced age
-- pregnant
-- DM
-- immunocompromised
-- recent antibiotic use
-- functional of anatomic abnormality of urinary tract
-- indwelling devices (foley)
-- hospital acquired
-- symptoms >7 days

 

[Instatewaiter]

What is the typical treatment plan for UTIs? Here's what I know:

Nitrofurantoin if uncomplicated

TMP-SMX if complicated

But what if the patient has a sulfa allergy? What if TMP-SMX doesn't work?

Aminoglycosides or fluoroquinolones first?
Sorry this is a pretty obvious question but I just suck at pharm

Ceftriaxone

Also fluoroquinolone resistance is expanding rapidly