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
...g a Treatment Regimen...
Acute Uncomplicated Cyst...
...ntoin monohydrate/macrocrystals 100 mg bi...
...P-SMX DS bid for 3 days is an appro...
...threshold of 20% as the resistance pre...
...ountries and regions, trimethoprim...
...a are insufficient to make a recommendati...
...ycin tromethamine 3 g single-dose i...
...ecillinam 400 mg bid for 3 to 7 days is an approp...
...luoroquinolones ofloxacin, ciprofloxacin...
...have a propensity for collateral damage and sh...
...m agents including amoxicillin-clavulana...
...lactams, such as cephalexin, are less well stu...
...lactams generally have inferior efficac...
...n or ampicillin should NOT be used for...
...e Pyelonephritis...
...uspected of pyelonephritis, a urine culture and...
...l ciprofloxacin 500 mg bid for 7 days with or wi...
...itial one-time IV agent is utilized...
...nce of fluoroquinolone resistance is...
...consolidated 24-hour dose of an aminoglycosi...
A once-daily oral fluoroquinolone, including c...
...id for 14 days is an appropriate choice for thera...
...consolidated 24-hour dose of an aminoglycoside i...
...pyelonephritis requiring hospitalization should b...
...ated Urinary Tract Infection...
...le 1. Antibiotics for Acute Uncomplica...