Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women
Key Points
Key Points
- Preferred antibiotics for acute cystitis are nitrofurantoin, or trimethoprim-sulfamethoxazole (TMP-SMX) if local resistance rates are < 20%.
- In patients suspected of pyelonephritis, a urine culture and susceptibility testing should always be performed.
- Preferred antibiotics for outpatient pyelonephritis are a fluoroquinolone or TMP-SMX. Consider an initial single-dose IV ceftriaxone or an aminoglycoside if community resistance is > 10% or, for TMP-SMX, if susceptibility unknown.
- Women with pyelonephritis requiring hospitalization should be initially treated with an IV antimicrobial regimen such as a fluoroquinolone, an aminoglycoside with or without ampicillin, an extended-spectrum cephalosporin or extended-spectrum penicillin with or without an aminoglycoside, or a carbapenem.
Selecting a Treatment Regimen
...cting a Treatment Regi...
...cute Uncomplicated Cysti...
...monohydrate/macrocrystals 100 mg bid for 5 days is...
...MP-SMX DS bid for 3 days is an appropriate c...
Notes: The threshold of 20% as the resistance prev...
...tries and regions, trimethoprim 100 mg bi...
...insufficient to make a recommendatio...
Fosfomycin tromethamine 3 g single...
...nam 400 mg bid for 3 to 7 days is an app...
...e fluoroquinolones ofloxacin, ciprofloxacin, a...
...nsity for collateral damage and should be res...
...²-Lactam agents including amoxicillin...
...actams, such as cephalexin, are les...
...generally have inferior efficacy and more ad...
...illin or ampicillin should NOT be us...
...e Pyelonephritis...
...spected of pyelonephritis, a urine culture...
...rofloxacin 500 mg bid for 7 days with or without...
...f an initial one-time IV agent is uti...
...e of fluoroquinolone resistance is thought...
...dated 24-hour dose of an aminoglycoside is reco...
...oral fluoroquinolone, including ciprofloxacin 1...
...P-SMX DS bid for 14 days is an appropriate choic...
...a consolidated 24-hour dose of an aminoglycos...
...lonephritis requiring hospitalization sh...
...d Urinary Tract Infections...
...ntibiotics for Acute Uncomplicated CystitisHaving...