urosepsis
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Introduction
Also see pyelonephritis.
Etiology
- prostatitis most common cause of urosepsis in men[2]
Laboratory
Radiology
- routine imaging not indicated
- renal & bladder ultrasound*
- abdominal radiograph* (KUB)
* initial tests in men
Management
- supportive therapy
- hospitalization
- fluid & blood pressure support (treat sepsis & septic shock)
- antibiotic therapy (empiric therapy)
- parenteral (IV) antibiotics (monotherapy)
- cefazolin 1 g every 8 hours
- ceftriaxone 1 g every 12-24 hours
- aztreonam 1-2 g every 8 hours
- severely ill or resistant Gm- bacilli suspected
- combination therapy (IV)
- cefepime for urosepsis in men[2]
- ceftazidime 1-2 g every 8 hours, plus
- quinolone (i.e. levofloxacin), plus
- aminoglycoside
- meropenem vaborbactam vs piperacillin-tazobactam
- combination therapy (IV)
- 7 days of antibiotic therapy comparable to 10 days when transition to oral antibiotics with comparable IV & oral bioavailability is feasible[3]
- 10 days of therapy in other patients[3]
- chronic catheter-associated urosepsis
- combination therapy (IV)
- ampicillin 1-2 g every 6 hours, plus
- quinolone, aminoglycoside, or aztreonam
- combination therapy (IV)
- parenteral (IV) antibiotics (monotherapy)
More general terms
Additional terms
References
- ↑ Norman D, UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 2.0 2.1 2.2 Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
- ↑ 3.0 3.1 3.2 McAteer J, Lee JH, Cosgrove SE et al. Defining the optimal duration of therapy for hospitalized patients with complicated urinary tract infections and associated bacteremia. Clin Infect Dis 2023 Jan 12; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36633559 https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciad009/6986293