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UTI & Pyelonephritis (ii) - Coggle Diagram
UTI & Pyelonephritis (ii)
Prevention
ensure washout of organisms
high fluid intake
regular voiding
ensure complete bladder emptying e.g. double micturition
prevent/tx constipation
good perineal hygiene
lactobacillus acidophilus probiotic
antibiotic prophylaxis
controversial
given for under 2s with congenital abnormality
trimethoprim, nitrofurantoin, cephalexin - avoid broad spectrum
circumcision
UTI more common when not circumcised, but circumcision not routine
can be helpful if upper GUT abnormalities / spina bifida (regular catheterisation)
Management
if <30mo admit to hosp for IV antibiotics, switch to PO when temp settled
if acute pyelonephritis usually IV first followed by PO for 7-10d
start on co-amox, adjust according to C+S
if cystitis PO antibiotics for 3d
Predisposing host factors
renal/urinary tract abnormality
incomplete bladder emptying
infrequent voiding, results in bladder enlargement
vulvitis
residual post micturition bladder vols
constipation
VUR