012-3-11 Treatment of bacteriuria Treatment of urosepsis treated unless the patient is febrile or has other evidence treatment must start as early as possible of systemic infection a Antibiotis should be given intravenously m Administration of antibiotics to catheterized patients a Previous antibiotic treatment should always be ascertained, because such treatment may have with asymptomatic bacteriuria inevitably results in multi- resulted in resistant organisms resistant and difficult-to-treat organisms Treatment of funguria Follow-up a Funguria can be treated with fluconazole 400 a Patients with sporadic, uncomplicated cystitis do not equire follow-up mg once daily for 1 day, followed by 200 mg once daily for 7 to 14 days a Patients with symptomatic recurrences, pyelonephritis, or complicated UTI should be observed a Funguria in catheterized patients should be m Follow-up cultures are important because bacteriuria treated only when there is a symptomatic UTI may persist and cause renal damage in afebri Follow-up procedures in patients with Decision process for upper(pyelonephritis) UTIs other than sporadic cystitis and lower(cystitis) urinary tract infections PYELONEPHRITIS PROCEDURE RECOMMENDATION SIGNS AND SYMPTOMS Urine culture All patients with pyelonephritis, complicated fections, or frequent recurrences: 4-5 days and Puna test Always pertorm together with unne culture 4-5 days and 3 wk after treatment Flank pain After py to exclude scars from childhood IAGNOSIS Puna Nitrite test Normally positive Normally positi Serum creatinine deddy: 3-4 wk after treatment in tients with pyelonephritis -eactive protein creased Urine osmolality Verification of suspected pyelonephritis Blood cultures Negative Positive in*30062012-3-11 9 Treatment of bacteriuria „ Bacteriuria in patients with catheters should not be treated unless the patient is febrile or has other evidence of systemic infection. „ Administration of antibiotics to catheterizaed patients with asymptomatic bacteriuria inevitably results in multi￾resistant and difficult-to-treat organisms Treatment of urosepsis „ In patients with suspected urosepsis, antibiotic treatment must start as early as possible. „ Antibiotis should be g y iven intravenously. „ Previous antibiotic treatment should always be ascertained, because such treatment may have resulted in resistant organisms. Treatment of funguria „ Funguria can be treated with fluconazole 400 mg once daily for 1 day, followed by 200 mg once daily y for 7 to 14 days. „ Funguria in catheterized patients should be treated only when there is a symptomatic UTI. Follow-up „ Patients with sporadic, uncomplicated cystitis do not require follow-up. „ Patients with symptomatic recurrences, pyelonephritis, or complicated UTI should be observed. „ Follow-up cultures are important because bacteriuria may persist and cause renal damage in afebrile pyelonephritis patients. Follow-up procedures in patients with UTIs other than sporadic cystitis Decision process for upper(pyelonephritis) and lower(cystitis) urinary tract infections