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
Selecting a Treatment...
...cute Uncomplicated Cysti...
...itrofurantoin monohydrate/macrocrystals...
...for 3 days is an appropriate choice for therapy,...
...threshold of 20% as the resistance...
In some countries and regions, trimethoprim 100 m...
...sfomycin tromethamine 3 g single-dose...
...illinam 400 mg bid for 3 to 7 days is an ap...
...e highly efficacious. ( A , I...
...pensity for collateral damage and should...
...m agents including amoxicillin-clavulana...
...ms, such as cephalexin, are less well st...
...actams generally have inferior efficacy...
659
...ampicillin should NOT be used for empiri...
...Pyelonephritis...
...ected of pyelonephritis, a urine culture and susce...
...floxacin 500 mg bid for 7 days wit...
...ial one-time IV agent is utilized, a...
...initial one-time IV dose of a long-acti...
...r a consolidated 24-hour dose of an amin...
...e-daily oral fluoroquinolone, inclu...
...m-sulfamethoxazole (TMP-SMX) bid fo...
...tial IV dose of a long-acting parentera...
...nsolidated 24-hour dose of an aminoglycoside is r...
...lonephritis requiring hospitalization should...
...ted Urinary Tract Infections...
Table 1. Antibiotics for Acute Unc...