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CONTINUING PROFESSIONAL DEVELOPMENT
11. Brusch JL. Urinary tract infections in diabetes mellitus. In:
Medscape. 2015. At: http://emedicine.medscape.com/
12. Nitzan O, Elias M, Chazan B, et al. Urinary tract infections in
patients with type 2 diabetes: review of the evidence of
prevalence, diagnosis, and management. Diabetes Metab
Syndr Obes 2015;8:129–36 .
13. Bramble FJ, Morley R. Drug-induced cystitis: the need for
vigilance. Br J Urol 1997;79(1):3–7 .
14. Mayo clinic. Cystitis: causes. 2015. At: www.mayoclinic.org/
15. NPS MedicineWise. Dapagliflozin (Forxiga) and canagliflozin
(Invokana) sodium–glucose co-transporter-2 inhibitors for
add-on therapy in type 2 diabetes mellitus. In: NPS radar.
2013. At: www.nps.org.au/publications/health-professional/
16. Johnsson KM, Ptaszynska A, Schmitz B, et al. Urinary
tract infections in patients with diabetes treated with
dapagliflozin. J Diabetes Complications 2013;27(5):473–8 .
17. Geerlings S, Fonseca V, Castro-Diaz D, et al. Genital and
urinary infections in diabetes: impact of pharmacologically-
induced glucosuria. Diabetes Res Clin Pract
18. Acute cystitis in adults (revised Oct 2014). In: eTG complete.
Melbourne: Therapeutic Guidelines; 2015.
19. Jarvis TR, Chan L, Gottlieb T. Assessment and management
of lower urinary tract infection in adults. Aust Prescr
1. A variety of factors can increase the
chances of, or worsen symptoms
of a urinary tract infection (UTI). Of
the following options, which ONE
of the following is NOT one of these
b) Acidic foods.
c) Frequent sexual activity.
d) Fermented foods.
2. Which ONE of the following
statements is CORRECT?
a) Postmenopausal women are at a lower
risk of UTIs due to low circulating
b) A common risk factor for UTIs in older
women is sexual activity.
c) Urinary calculi are strictly asymptomatic
and do not cause bladder symptoms.
d) Dapagliflozin-associated UTIs are more
common in women.
3. Sally is a 33-year-old patient who
is being treated for a UTI. Sally is
currently pregnant (in first trimester).
Which ONE of the following
treatment options for Sally is
a) Trimethoprim 300 mg daily for 3 days.
b) Cephalexin 500 mg twice daily for
c) Nitrofurantoin 100 mg twice daily for
d) Amoxycillin + clavulanate (500+125 mg)
twice daily for 5 days.
4. There is an association between
(SGLT2) inhibitors and UTIs. Which
ONE of the following is CORRECT?
a) SGLT2 inhibitors result in decreased
urinary excretion of glucose, which
increases the risk of UTIs in patients with
b) SGLT2 inhibitors cause increased
glucose absorption, which increases the
risk of UTIs in patients with diabetes.
c) SGLT2 inhibitors result in increased
urinary glucose levels, which increase
the risk of UTIs in patients with diabetes.
d) SGLT2 inhibitors can cause poor
metabolic control, which increases the
risk of UTIs in patients with diabetes.
5. In the management of UTIs, which
ONE of the following is INCORRECT?
a) Dapagliflozin-induced UTIs almost
always result in SGLT2-treatment
b) Urinary alkalinisers are a suitable option
for symptomatic relief of a UTI.
c) Norfloxacin is considered first-line
therapy for UTIs.
d) Nitrofurantoin is the preferred agent for
chronic cases of UTIs as it can safely be
KEY LEARNING POINTS
There are a variety of causes of UTIs and
bladder symptoms. In patients with
diabetes, there is a higher incidence of
UTIs related to numerous physiological
factors associated with this condition.
If patients with diabetes present to the
pharmacy with symptoms of a UTI, it
is essential that diabetes control and
current medicines are reviewed, as
these could be compounding factors to
consider in the overall management of
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infections in postmenopausal women. Arch Intern Med
3. NHS choices. Urinary tract infections in adults - causes.
2014. At: www.nhs.uk/Conditions/urinary-tract-infection-
4. Fihn SD. Acute uncomplicated urinary tract infection in
women. N Engl J Med 2003;349(3):259–66.
5. Kontiokari T, Laitinen J, Järvi L, et al. Dietary factors
protecting women from urinary tract infection. Am J Clin
Nutr 2003;77(3):600–4 .
6. Preminger GM. Urinary calculi (nephrolithiasis; stones;
urolithiasis). In: Merck manuals (professional version). 2014.
7. Mayo clinic. Bladder stones. 2013. At: www.mayoclinic.org/
8. Friedlander JI, Shorter B, Moldwin RM. Diet and its role in
interstitial cystitis/bladder pain syndrome (IC/BPS) and
comorbid conditions. BJU Int 2012;109(11):1584–91.
9. Maserejian NN, Wager CG, Giovannucci EL, et al. Intake
of caffeinated, carbonated, or citrus beverage types and
development of lower urinary tract symptoms in men and
women. Am J Epidemiol 2013;177(12):1399–410.
10. Hooton T. Pathogenesis of urinary tract infections: an
update. J Antimicrob Chemother 2000;46(S1):1–7 .
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