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Management

Management. Urinary Tract Infection. Management: Urinary Tract Infection. Diagnostic Tests Curative Specific Supportive Diet Physical Activity Prophylactic Preventive Health Care. Management: Diagnostic Tests. Urinalysis Ultrasound

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Management

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  1. Management Urinary Tract Infection

  2. Management: Urinary Tract Infection • Diagnostic Tests • Curative • Specific • Supportive • Diet • Physical Activity • Prophylactic • Preventive Health Care

  3. Management: Diagnostic Tests • Urinalysis • Ultrasound • rule out hydronephrosis & renal or perirenalabscesses • may show acute pyelonephritis

  4. Management: Diagnostic Tests • Voiding Cystourethrogram (VCUG) • indications: • All children younger than 5y/o • Any child with a febrile UTI • School aged girls who had 2 or more UTIs • Any male with UTI • most common finding is vesicoureteral reflux

  5. Management: Diagnostic Tests • Dimercaptosuccinic Acid Scan (DMSA Scan) • functional & obstruction anomaly • supports the diagnosis of pyelonephritis with a finding of photopenia • most sensitive & accurate study to demonstrate renal scarring

  6. Mangement: Curative • Specific • Antibiotics • Anti-pyretic • Analgesic

  7. Mangement : Curative • Trimethoprim-sulfamethoxazole (Co-trimoxazole) • folic acid synthesis inhibitor • given if culture & sensitivities are not yet available • effective against most strains of E.coli • dosing: 40 mkd SMX & 8 mkd TMP q 12 h • preparation: 200mg SMX & 40mg TMP/ 5ml • AE: Stevens-Johnson Syndrome, hepatitis, cholestaticjaundice, megaloblasticanemia

  8. Management : Curative • Amoxicillin, Ampicillin • interferes with bacterial cell wall synthesis • also effective as TMP-SMX • dosing: 40 mkd q 8 h • preparation: 100mg/ml, 125mg/5ml, 250mg/5ml • AE: Diarrhea, indigestion, occassional rash either urticarial or erythematous

  9. Management : Curative • Cephalosporins • 2nd or 3rd generation • Inhibits cell wall synthesis • dosing: 25-50 mkd q 6 h • preparation: 100mg/ml, 125mg/5ml, 250mg/5ml • AE: thrombophlebitis, diarrhea

  10. Management : Curative • Ciprofloxacin • inhibits DNA Gyraseandtopoisomerase IV preventing replication and repair • alternative agent for resistant microorganisms like Pseudomonas • dosing: 20-30 mkd q 12 h • preparation: 100 mg, 250 mg, 500 mg, 750mg, 1000 mg • AE: arthropathy, tendon damage, torsades de pointes

  11. Management : Curative • Gentamicin • inhibits bacterial protein synthesis • combined with ampicillin • dosing: 40 mkd q 6 h • preparation: 100mg/2.5ml, 200mg/5ml, 400mg/5ml • AE: ototoxicity, nephrotoxicity

  12. Management : Curative • Paracetamol • inhibits COX • anti-pyretic and analgesic • dosing: 10-15 mkd q 4 h • preparation: 125mg/5ml, 250mg/5ml • AE: ototoxicity, nephrotoxicity

  13. Management : Curative • Supportive • Diet • Increased oral fluid intake • Physical Activity • Frequent voiding • Prophylactic • Proper genital hygiene • Strict hand-washing • Avoid infrequent voiding

  14. Management: Preventive Health Care • At 3 years of age: • Vaccines • MMR 2 • Varicela • Influenza • Blood pressure monitoring • Nutrition counseling

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