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
...ting a Treatment Regim...
...complicated Cystitis
...itrofurantoin monohydrate/macrocry...
...MP-SMX DS bid for 3 days is an appropriate cho...
Notes: The threshold of 20% as the resistance pr...
...ries and regions, trimethoprim 100 mg bid for...
Data are insufficient to make a reco...
...n tromethamine 3 g single-dose is an ap...
...llinam 400 mg bid for 3 to 7 days is an ap...
...uinolones ofloxacin, ciprofloxacin, and levofl...
...have a propensity for collateral damag...
...s including amoxicillin-clavulanat...
...her β-lactams, such as cephalexin, are...
...ms generally have inferior efficacy and mo...
...lin or ampicillin should NOT be used for empiric...
...Pyelonephritis...
...ients suspected of pyelonephritis, a urine cul...
...ofloxacin 500 mg bid for 7 days with or without an...
...an initial one-time IV agent is utilized,...
...e of fluoroquinolone resistance is...
...consolidated 24-hour dose of an aminoglycosi...
...ly oral fluoroquinolone, including ci...
...DS bid for 14 days is an appropriat...
...idated 24-hour dose of an aminogly...
...en with pyelonephritis requiring hospitalization...
...omplicated Urinary Tract Infect...
...ntibiotics for Acute Uncomplicated Cyst...