-
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:
------------------------------------
Review Articles: Current Concepts: 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.
Original Article: Bacteriuria in the Catheterized Patient: What
Quantitative Level of Bacteriuria Is Relevant.
