Q: 78 year old male resident of assisted living facility presented to ER with severe pain going from 'loin to groin'. You suspect urosepsis. Indeed UA (urine analysis) showed WBC, and nitrites. Urine PH is reported 8. What would be your concideration in selecting antibiotics?



Answer: Cover Proteus, Pseudomonas, or Klebsiella.

Urea-splitting organism such as Proteus, Pseudomonas, or Klebsiella are likely to cause urine pH greater than 8.0 - and should be covered with antibiotics while cultures are pending.