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 Treat...
...Acute Un...
...ofurantoin monohydrate/macrocrystals 100 mg bid...
...MP-SMX DS bid for 3 days is an appropriate...
...s: The threshold of 20% as the resistanc...
...ountries and regions, trimethoprim 100 mg bid fo...
...nsufficient to make a recommendation for other c...
...mycin tromethamine 3 g single-dose is...
...400 mg bid for 3 to 7 days is an appropr...
...fluoroquinolones ofloxacin, ciprofloxacin, and le...
...a propensity for collateral damage and s...
...-Lactam agents including amoxicill...
...tams, such as cephalexin, are less we...
...generally have inferior efficacy a...
...cillin or ampicillin should NOT be us...
...Acute Pyelone...
...pected of pyelonephritis, a urine...
...ral ciprofloxacin 500 mg bid for 7 da...
...initial one-time IV agent is utiliz...
...alence of fluoroquinolone resistance is thought to...
...d 24-hour dose of an aminoglycoside is rec...
...al fluoroquinolone, including ciprofloxacin 1000...
...bid for 14 days is an appropriate choic...
...idated 24-hour dose of an aminoglycoside i...
...n with pyelonephritis requiring hospitalization...
...ncomplicated Urinary Tract Infect...
...ntibiotics for Acute Uncomplicated Cyst...