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 Regim...
...Uncomplicated Cystitis...
Nitrofurantoin monohydrate/macrocrystals...
...DS bid for 3 days is an appropriate choi...
Notes: The threshold of 20% as the resistance prev...
...countries and regions, trimethoprim 10...
...are insufficient to make a recommendation...
...omethamine 3 g single-dose is an a...
...illinam 400 mg bid for 3 to 7 days is an appropr...
...uoroquinolones ofloxacin, ciprofloxaci...
...ut have a propensity for collateral damage and...
...nts including amoxicillin-clavulanate, c...
...β-lactams, such as cephalexin, are less well stud...
...he β-lactams generally have inferior ef...
...oxicillin or ampicillin should NOT be u...
...cute Pyelonephriti...
...pected of pyelonephritis, a urine culture and susc...
...in 500 mg bid for 7 days with or without...
...itial one-time IV agent is utilized, a lo...
...nce of fluoroquinolone resistance is thought to ex...
...onsolidated 24-hour dose of an aminoglycosid...
A once-daily oral fluoroquinolone,...
...bid for 14 days is an appropriate cho...
...dated 24-hour dose of an aminoglycos...
...nephritis requiring hospitalization s...
...ated Urinary Tract Infections...
...able 1. Antibiotics for Acute Uncomplica...