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 T...
Acute...
...oin monohydrate/macrocrystals 100 mg bid...
...for 3 days is an appropriate choice f...
...tes: The threshold of 20% as the r...
...n some countries and regions, trimethoprim 100 mg...
...ta are insufficient to make a recommendation for...
...omethamine 3 g single-dose is an appropri...
...llinam 400 mg bid for 3 to 7 days is an appro...
...e fluoroquinolones ofloxacin, ciprofloxacin, and...
but have a propensity for collateral damage...
...actam agents including amoxicillin-clavulana...
Other β-lactams, such as cephalexin, are less w...
...he β-lactams generally have inferior efficacy an...
...moxicillin or ampicillin should NOT be...
...Acute...
...suspected of pyelonephritis, a urine cultu...
...ciprofloxacin 500 mg bid for 7 days with or witho...
...one-time IV agent is utilized, a long-a...
...prevalence of fluoroquinolone resistance is t...
...idated 24-hour dose of an aminoglycoside...
...y oral fluoroquinolone, including ciprofloxacin...
TMP-SMX DS bid for 14 days is an appropriate cho...
or a consolidated 24-hour dose of an amino...
...with pyelonephritis requiring hospi...
...ed Urinary Tract Infections...
...able 1. Antibiotics for Acute Uncomplicated Cyst...