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Antimicrobial prescribing: NHS Forth Valley
Acute Hospital Guidance
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Urinary Tract Infections
Lower UTI in Chronic Kidney Disease (or in AKI)

Update your RDS mobile app to v4.7.1 to download toolkits even when website is down.

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. You will see that each toolkit has a small QR code icon in the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively update to the latest release - RDS app version 4.7.1 - to see this improvement.

Updating to this latest version of the RDS app is also strongly recommended to get the full benefits of the new resilience arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Lower UTI in Chronic Kidney Disease (or in AKI)

Antimicrobial prescribing: NHS Forth Valley

NHS Forth Valley

CKD 4

Important: Therapy

Trimethoprim (with caution) 200mg PO 12 hourly

or

Cefalexin 500mg PO 12 hourly

or

Fosfomycin 3g stat for female UTI (repeat 3g dose after 72 hours in male UTI)

Notes:

CKD 5

Important: Therapy

Cefalexin 250mg PO 12 hourly

or

If eGFR >10ml/min - Fosfomycin 3g stat for female UTI (repeat 3g dose after 72 hours in male UTI)

Notes:

Important: Notes

Avoid nitrofurantoin in patients with CKD 4 or 5.
Trimethoprim can be used in patients with CKD 3 (unless baseline K is high). Trimethoprim can cause a temporary increase in serum potassium and creatinine during treatment.
Ensure samples are marked with CKD 4 or 5 (or AKI) to allow lab to report appropriately.

Alternative option for CKD4 or 5 if no other options suitable e.g. allergy, resistance:

Ciprofloxacin 250mg PO 12 hourly (consider safety issues)

Treatment duration:

Female UTI - 3 days

Male UTI - 7 days

Reference - Renal Drug Database.

To get access to the Renal Drug Database - email knowledge@nes.scot.nhs.uk to request an individual login.