Podcast #131: Antibiotics for a UTI - The Emergency Medical Minute

Podcast #131: Antibiotics for a UTI

0242783e-863a-451d-a9e4-4455434c30daRun Time: 4 minutes

Author: Holly Anderson, PharmD PGY-1 Resident

Educational Pearls:

  • Patients with pyelonephritis typically show a leukocytosis, fever, nausea, HA, CVA tenderness. Patients with a lower tract UTI will have absence of systemic symptoms with predominantly voiding symptoms of frequency, urgency, dysuria, and hematuria. These 2 types of UTI require different antibiotics and treatment.
  • Based on IDSA guidelines, only patients with uncomplicated lower UTI should be receiving Macrobid.
  • For patients with uncomplicated pyelonephritis, fluoroquinolones and Bactrim are preferred.
  • Macrobid has good sensitivity for the classic bugs that cause UTI, while fluoroquinolones show increasing E. coli resistance and are not recommended for uncomplicated lower tract UTIs.
  • Macrobid should not be used for pyelonephritis because the medication penetrates to the bladder just fine, but not well enough to the kidneys.

References: http://www.idsociety.org/Guidelines/Patient_Care/IDSA_Practice_Guidelines/Infections_by_Organ_System/Genitourinary/Uncomplicated_Cystitis_and_Pyelonephritis_(UTI)/

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