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Acute Cystitis in Pregnancy

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1. Acute cystitis

Acute cystitis Acute cystitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Acute cystitis Last reviewed: February 2019 Last updated: February 2019 Summary Most common aetiological organisms are Escherichia coli (80%), Staphylococcus saprophyticus (4%), Klebsiella pneumoniae (4%), and Proteus mirabilis (4%), followed by other bacteria (9%). For uncomplicated acute cystitis, first-line treatment is 3 days (...) of trimethoprim/sulfamethoxazole or trimethoprim, or 5 days of nitrofurantoin. For complicated cases of cystitis, first line is empirical therapy with a fluoroquinolone antibiotic for 7 to 14 days; treatment should be adjusted based on the results of the urine culture. Complicating characteristics include pregnancy; recent instrumentation, including catheterisation or indwelling catheter; male patient; diabetes, immunosuppression; structurally or functionally abnormal urinary bladder; history of recurrent

2019 BMJ Best Practice

2. Acute cystitis

Acute cystitis Acute cystitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Acute cystitis Last reviewed: February 2019 Last updated: February 2019 Summary Most common aetiological organisms are Escherichia coli (80%), Staphylococcus saprophyticus (4%), Klebsiella pneumoniae (4%), and Proteus mirabilis (4%), followed by other bacteria (9%). For uncomplicated acute cystitis, first-line treatment is 3 days (...) of trimethoprim/sulfamethoxazole or trimethoprim, or 5 days of nitrofurantoin. For complicated cases of cystitis, first line is empirical therapy with a fluoroquinolone antibiotic for 7 to 14 days; treatment should be adjusted based on the results of the urine culture. Complicating characteristics include pregnancy; recent instrumentation, including catheterisation or indwelling catheter; male patient; diabetes, immunosuppression; structurally or functionally abnormal urinary bladder; history of recurrent

2018 BMJ Best Practice

3. Acute Cystitis in Pregnancy

Acute Cystitis in Pregnancy Acute Cystitis in Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Acute Cystitis in Pregnancy (...) Acute Cystitis in Pregnancy Aka: Acute Cystitis in Pregnancy , Asymptomatic Bacteriuria in Pregnancy , UTI in Pregnancy , Urinary Tract Infection in Pregnancy II. Epidemiology in 2 to 7% of pregnancies Significant cause of III. Etiology (most common) miribilis Pseudomonas aeruginosa saprophyticus IV. History Urinary Urgency Symptoms suggestive of Flank pain or Past Medical History s itis Predisposes to V. Signs of cystitis (Contrast with Pyelonephritis) Afebrile No Costovertebral angle (CVA

2018 FP Notebook

4. CRACKCast E177 – Acute Complications of Pregnancy

CRACKCast E177 – Acute Complications of Pregnancy CRACKCast E177 - Acute Complications of Pregnancy - CanadiEM CRACKCast E177 – Acute Complications of Pregnancy In by Adam Thomas May 14, 2018 This episode of CRACKCast covers Rosen’s Chapter 177, Acute Complications of Pregnancy. This chapter covers many acute issues that arise during the unique physiologic state that is pregnancy, from first trimester bleeding to diagnostic challenges and management of other conditions during pregnancy. Also (...) in pregnancy. Clinical presentations may be atypical. Cholelithiasis presents with similar symptoms to those in nonpregnant women and is similarly diagnosed through ultrasound. Surgery, if required, is optimally done during the second trimester. Hepatitis is the most common cause of liver disease in pregnancy; Acute fatty liver of pregnancy is a rare disorder of the third trimester that can result in hepatic failure, complicated labor, and fetal mortality. Coagulopathy, jaundice, seizures, DIC, and hepatic

2018 CandiEM

5. Pregnant women: urinary colonisation and cystitis

Pregnant women: urinary colonisation and cystitis Urinary colonisation in pregnant women Screening: • in women without a particular risk of urinary infection: urine test strip (UTS) every month starting from the 4 th month of pregnancy. If the UTS is positive (positive for leukocytes or nitrites), a cytobacteriological examination of the urine (CBEU) must be performed; • in women at risk of urinary infection (underlying organic or functional uropathy, diabetes, history of acute recurring (...) cystitis): a CBEU is performed (bacteriuria = 10 -5 CFU/ml irrespective of the microorganism) at the first follow-up consultation for the pregnancy, and then every month from the 4 th month. Treatment adjusted to the results of the antibiotic sensitivity testing must be started once the results have been obtained (no probabilistic treatment). The following treatments are recommended: Follow-up CBEU at 8 to 10 days after completion of treatment, then CBEU once a month until the birth

2016 HAS Guidelines

6. Fosfomycin: A First-Line Oral Therapy for Acute Uncomplicated Cystitis (PubMed)

Fosfomycin: A First-Line Oral Therapy for Acute Uncomplicated Cystitis Fosfomycin is a new agent to Canada approved for the treatment of acute uncomplicated cystitis (AUC) in adult women infected with susceptible isolates of E. coli and Enterococcus faecalis. We reviewed the literature regarding the use of oral fosfomycin for the treatment of AUC. All English-language references from 1975 to October 2015 were reviewed. In Canada, fosfomycin tromethamine is manufactured as Monurol® (...) , its favorable safety profile including pregnancy patients, drug interactions, and clinical trials data demonstrating efficacy in AUC, has resulted in Canadian, US, and European guidelines/authorities recommending fosfomycin as a first line agent for the treatment of AUC.

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2016 The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale

7. Pregnancy and Renal Disease

Pregnancy and Renal Disease Clinical Practice Guideline Pregnancy and Renal Disease Authors: Kate Wiles - Chair NIHR Doctoral Research Fellow in Obstetric Nephrology, Guy’s and St. Thomas’ NHS Foundation Trust and King's College London Lucy Chappell Professor of Obstetrics, King's College London and Consultant Obstetrician, Guy’s and St. Thomas’ NHS Foundation Trust Katherine Clark Specialist Midwife, King’s College Hospital NHS Foundation Trust Louise Elman Expert Patient Matt Hall Consultant (...) Nephrologist, King’s College Hospital NHS Foundation Trust and King’s College London Final Version: September 2019 Review Date: September 2024 Renal Association Clinical Practice Guideline Pregnancy and Renal Disease – September 2019 2 Endorsements The National Institute for Health and Care Excellence (NICE) has accredited the process used by the Renal Association to produce its Clinical Practice Guidelines. Accreditation is valid for 5 years from January 2017. More information on accreditation can

2019 Renal Association

8. Pentosan polysulfate sodium (Elmiron) - Interstitial Cystitis

Pentosan polysulfate sodium (Elmiron) - Interstitial Cystitis 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2017. Reproduction is authorised provided the source is acknowledged. 23 March 2016 EMA/287422/2017 Committee for Medicinal Products for Human Use (CHMP) Assessment report elmiron (...) International Society for the Study of Bladder Pain Syndrome EU European Union FDA Food and Drug Administration FT-IR Fourrier Transform Infrared Spectroscopy GAG Glycosaminoglycan GPC Gel permeation chromatography GRA global response assessment GTI gastrointestinal HDPE High Density Polyethylene HPLC high performance liquid chromatography HSCIC Health and Social Care Information Centre IC Interstitial Cystitis ICH International Conference on Harmonisation of Technical Requirements for Registration of ICPI

2017 European Medicines Agency - EPARs

9. Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome

Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome Intertitial Cystitis (IC/BPS) Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning (...) ' Network (PMN) Patient Safety and Quality of Care Accreditations and Reporting Patient Education Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome (2014) Published 2011; Amended 2014 The purpose of this clinical guideline is to provide a clinical framework for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), including discussion of first through sixth line treatments and treatments that should not be offered. [pdf] [pdf] Panel Members Philip M

2014 American Urological Association

10. Assessment of abdominal pain in pregnancy

, and perinatal death. Differentials Miscarriage Ectopic pregnancy Pre-term labour Adnexal mass Acute cystitis Placental abruption Uterine rupture Acute pyelonephritis Nephrolithiasis Acute hydronephrosis Ruptured ovarian cyst Haemorrhagic ovarian cyst Adnexal torsion Appendicitis Cholecystitis Acute pancreatitis Intestinal obstruction Uterine fibroids Chorioamnionitis Haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome Acute fatty liver of pregnancy Ovarian hyper-stimulation syndrome (...) about the health of their fetus. Patients require a careful assessment in order to reduce anxiety and give reassurance. If the clinical picture is unclear, a specialist should be consulted. Chamberlain G. ABC of antenatal care: abdominal pain in pregnancy. BMJ. 1991;302:390-1394. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1670063/pdf/bmj00129-0073.pdf http://www.ncbi.nlm.nih.gov/pubmed/2059722?tool=bestpractice.com Augustin G, Majerovic M. Non-obstetrical acute abdomen during pregnancy. Eur J

2018 BMJ Best Practice

11. Acute Cystitis in Pregnancy

Acute Cystitis in Pregnancy Acute Cystitis in Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Acute Cystitis in Pregnancy (...) Acute Cystitis in Pregnancy Aka: Acute Cystitis in Pregnancy , Asymptomatic Bacteriuria in Pregnancy , UTI in Pregnancy , Urinary Tract Infection in Pregnancy II. Epidemiology in 2 to 7% of pregnancies Significant cause of III. Etiology (most common) miribilis Pseudomonas aeruginosa saprophyticus IV. History Urinary Urgency Symptoms suggestive of Flank pain or Past Medical History s itis Predisposes to V. Signs of cystitis (Contrast with Pyelonephritis) Afebrile No Costovertebral angle (CVA

2015 FP Notebook

12. Recurrent Cystitis

with anaerobic organisms (except , ) Recurrent or treatment-resistant Voiding dysfunction Urinary obstructive symptoms Increased post-void X. Management: Urinary Tract Infection Treatment See for acute management First-line agents (less likely to induce ) Trimethoprim-sulfamethoxazole or , (3 days) or (5 days) Fosfomycin or monurol (1 day) Other agents Reserve s (e.g. , ) for more complicated infections Beta lactam agents ( s, s) are less effective in Recurrent UTI Precautions Treat uncomplicated cystitis (...) with three day course Outside pregnancy, avoid treating asymptomatic residual bacteriuria after treatment Treat uncomplicated cystitis in with same agents as those without diabetes XI. Management: Antibiotic self-starting regimen for symptomatic UTI Emergency prescription available to start after onset of classic symptoms Self diagnosis based on , , urinary hesitancy is 85% accurate Choose a 3 day antibiotic course See for antibiotic options and dosing Indications for medical evaluation Symptoms last

2018 FP Notebook

13. WHO recommendations on antenatal care for a positive pregnancy experience

WHO recommendations on antenatal care for a positive pregnancy experience WHO recommendations on antenatal care for a positive pregnancy experienceWHO Library Cataloguing-in-Publication Data WHO recommendations on antenatal care for a positive pregnancy experience. I.World Health Organization. ISBN 978 92 4 154991 2 Subject headings are available from WHO institutional repository © World Health Organization 2016 All rights reserved. Publications of the World Health Organization are available (...) of declarations of interest from the Guideline Development Group (GDG) members and how they were managed 143 Annex 4: Implementation considerations for ANC guideline recommendations 145 Web annexes: WHO recommendations on antenatal care for a positive pregnancy experience* Web annex 1: Priority questions and outcomes for the antenatal care (ANC) interventions identified for this guideline Web annex 2: Changes from the approved scope of this guideline Web annex 3: Guideline Development Group (GDG) judgements

2016 World Health Organisation Guidelines

14. The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs)

The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs) Dec2015 © EUnetHTA, 2015. Reproduction is authorised provided EUnetHTA is explicitly acknowledged 1 EUnetHTA Joint Action 3 WP4 Version 1.4, +31 January 2019] Rapid assessment of other technologies using the HTA Core Model ® for Rapid Relative Effectiveness Assessment C-REACTIVE PROTEIN POINT-OF-CARE (...) TESTING (CRP POCT) TO GUIDE ANTIBIOTIC PRESCRIBING IN PRIMARY CARE SETTINGS FOR ACUTE RESPIRATORY TRACT INFECTIONS (RTIS) Project ID: OTCA012 C-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care EUnetHTA Joint Action 3 WP4 2 DOCUMENT HISTORY AND CONTRIBUTORS Version Date Description V1.0 26/10/2018 First draft. V1.1 03/12/2018 Input from co-author has been processed. V1.2 03/12/2018 Input from dedicated reviewers has been

2019 EUnetHTA

15. Intranasal Ketorolac Tromethamine (Sprix) for Acute Pain of Interstitial Cystitis Flare of Pain

Intranasal Ketorolac Tromethamine (Sprix) for Acute Pain of Interstitial Cystitis Flare of Pain Intranasal Ketorolac Tromethamine (Sprix) for Acute Pain of Interstitial Cystitis Flare of Pain - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Intranasal Ketorolac Tromethamine (Sprix) for Acute Pain of Interstitial Cystitis Flare of Pain The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02000401 Recruitment Status : Completed First Posted : December 4, 2013 Last Update Posted : December 4, 2013 Sponsor

2013 Clinical Trials

16. CRACKCast E033 – Acute Pelvic Pain in Women

patient <20 weeks or >20 weeks that is pregnancy related 1st trimester Ectopic pregnancy Threatened abortion / non-viable pregnancy Ovarian hyper stimulation syndrome (think if IVF) 2nd-3rd trimester Placenta previa Placental abruption Round ligament pain Braxston hicks WiseCracks: 1) List 6 life threatening causes of acute pelvic pain in women Life threatening diagnoses NOT to miss: PID Tubo-ovarian abscess Ectopic pregnancy Hemorrhagic ovarian cyst (ruptured) Appendicitis Bowel/uterine perforation 2 (...) ) Outline a systematic approach to acute pelvic pain in women Think: Reproductive tract / urinary tract / intestines / PREGNANCY Hx and physical are insufficient to rule in or out pathology ask about high risk sexual features use of fertility treatments or surgery Most acute serious pathologies have less than 48 hrs of pain Symptoms Lateral pain = ovary or tube pathology may also be appendix, diverticulitis or colic benign: mittelschmerz, luteum cyst Central pain = uterus or bladder pathology PID

2017 CandiEM

17. Proteinuria During Acute Pyelonephritis In Pregnancy

-hour urine protein excretion of 204.3 mg (± 92.5) was found in the non-hypertensive pregnant population. Physiological changes in pregnancy predispose patients to urinary tract infections; ureteral compression by the gravid uterus, progesterone-mediated slowing of ureteral peristalsis and decreased bladder tone, and mechanical compression of the bladder contribute to impaired clearance of bacteria from the urinary tract. Indeed, acute cystitis complicates 2-4% of all pregnancies. While it has been (...) criteria will be enrolled in the study. A 24 hour urine collection with be performed for evaluation of protein. Criteria Inclusion Criteria: Women ≥ 18 years old admitted at Miller Children and Women's Hospital Long Beach Memorial Medical Center Gestational age between 20 weeks and 0 days to 41 weeks and 0 days Singleton pregnancy Pyelonephritis group: meeting 2 out of 3 criteria: Fever > 100.4 Costovertebral angle tenderness Positive urine culture - without pyelonephritis group: without acute cystitis

2015 Clinical Trials

18. Assessment of UTI Symptoms and Quality of Life According to Antibiotics Treatment in Acute Uncomplicated Cystitis

Assessment of UTI Symptoms and Quality of Life According to Antibiotics Treatment in Acute Uncomplicated Cystitis Assessment of UTI Symptoms and Quality of Life According to Antibiotics Treatment in Acute Uncomplicated Cystitis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved (...) studies (100). Please remove one or more studies before adding more. Assessment of UTI Symptoms and Quality of Life According to Antibiotics Treatment in Acute Uncomplicated Cystitis The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01631955 Recruitment Status : Completed First Posted : June 29, 2012

2012 Clinical Trials

19. Pilot Study Evaluating the Efficacy of Certolizumab Pegol for Interstitial Cystitis

patients of child-bearing potential must have a negative serum pregnancy test at Screening and use birth control while in the study. O'Leary-Sant Interstitial Cystitis Symptom and Problem Indexes (OSPI) score ≥ 18 No history of any cancer. No bacterial cystitis in previous 1 month No active herpes in previous 3 months Never treated with cyclophosphamide No neurogenic bladder dysfunction (due to a spinal cord injury, stroke, Parkinson's disease, multiple sclerosis, spina bifida or diabetic cystopathy (...) Pilot Study Evaluating the Efficacy of Certolizumab Pegol for Interstitial Cystitis Pilot Study Evaluating the Efficacy of Certolizumab Pegol for Interstitial Cystitis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before

2015 Clinical Trials

20. Acute Abdomen and Pregnancy (Diagnosis)

that are incidental to pregnancy include the following: Pneumonia Additional causes of acute abdomen that are incidental to pregnancy include the following: Intraperitoneal hemorrhage [ ] Causes associated with pregnancy Pregnancy-associated conditions that cause acute abdomen include the following: Acute cystitis Rupture of the rectus abdominis Torsion of the pregnant uterus Conditions resulting from pregnancy that cause acute abdomen in early pregnancy include the following: Ruptured [ ] with peritonitis Acute (...) Acute Abdomen and Pregnancy (Diagnosis) Acute Abdomen and Pregnancy: Background, Etiology, Presentation Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTk1OTc2LW92ZXJ2aWV3 processing > Acute Abdomen and Pregnancy

2014 eMedicine Surgery

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