Template:Acute cystitis antibiotics: Difference between revisions
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===Women, Uncomplicated | ===Outpatient=== | ||
'''Women, Uncomplicated''' | |||
*[[Nitrofurantoin]] ER 100mg BID x 5d, OR | *[[Nitrofurantoin]] ER 100mg BID x 5d, OR | ||
*[[TMP/SMX]] DS (160/800mg) 1 tab BID x 3d, OR | *[[TMP/SMX]] DS (160/800mg) 1 tab BID x 3d (Females) x7days (Males), OR | ||
*[[Cephalexin]] 250mg QID x 5d, OR | *[[Cephalexin]] 250mg QID x 5d, OR | ||
*[[Ciprofloxacin]] 250mg BID x3d | *[[Ciprofloxacin]] 250mg BID x3d | ||
**Avoid using fluoroquinolone for the first-line treatment of uncomplicated urinary tract infections (UTIs) in women.<ref>Choosing Wisely. American Urogynecologic Society. http://www.choosingwisely.org/societies/american-urogynecologic-society</ref> | |||
*[[Fosfomycin]] 3 g PO once | |||
**Lower clinical and microbiologic success compared to nitrofurantoin TID for 5 days <ref>Huttner, A., Kowalczyk, A., Turjeman, A., Babich, T., Brossier, C., Eliakim-Raz, N., … Harbarth, S. (2018). Effect of 5-Day Nitrofurantoin vs Single-Dose Fosfomycin on Clinical Resolution of Uncomplicated Lower Urinary Tract Infection in Women: A Randomized Clinical Trial. JAMA: The Journal of the American Medical Association, 319(17), 1781–1789.</ref> | |||
'''Women, Complicated''' | |||
*[[Ciprofloxacin]] 500mg BID x10-14d, OR | |||
*[[Cefpodoxime]] 200 mg BID x10-14d | |||
'''Women, Concern for [[Urethritis]]''' | |||
* | *[[Ceftriaxone]] 250mg IM x1 AND [[azithromycin]] 1gm PO x1 AND [[nitrofurantoin]] ER 100mg BID x5d, OR | ||
*[[Levofloxacin]] 500mg QD x 14d (covers urinary pathogens, [[GC]], and [[chlamydia]]) | |||
**[[GC]] resistance to fluoroquinolones is increasing | |||
'''Men''' | |||
*[[Ciprofloxacin]] 500mg BID x10-14d, OR | |||
*[[Cefpodoxime]] 200 mg BID x10-14d | |||
* | |||
===Inpatient Options=== | ===Inpatient Options=== | ||
*[[Ciprofloxacin]] 400mg IV q12hr OR | *[[Ciprofloxacin]] 400mg IV q12hr, OR | ||
*[[Ceftriaxone]] 1gm IV QD OR | *[[Ceftriaxone]] 1gm IV QD, OR | ||
*Cefotaxime 1-2gm IV q8hr OR | *[[Cefotaxime]] 1-2gm IV q8hr, OR | ||
*[[Gentamicin]] 3mg/kg/day divided q8hr +/- ampicillin 1–2 gm q4hr OR | *[[Gentamicin]] 3mg/kg/day divided q8hr +/- ampicillin 1–2 gm q4hr, OR | ||
*[[Piperacillin/Tazobactam]] 3.375 gm IV q6hr OR | *[[Piperacillin/Tazobactam]] 3.375 gm IV q6hr, OR | ||
*[[Cefepime]] 2gm IV q8hr OR | *[[Cefepime]] 2gm IV q8hr, OR | ||
*[[Imipenem]] 500mg IV q8hr | *[[Imipenem]] 500mg IV q8hr | ||
Latest revision as of 15:42, 28 August 2025
Outpatient
Women, Uncomplicated
- Nitrofurantoin ER 100mg BID x 5d, OR
- TMP/SMX DS (160/800mg) 1 tab BID x 3d (Females) x7days (Males), OR
- Cephalexin 250mg QID x 5d, OR
- Ciprofloxacin 250mg BID x3d
- Avoid using fluoroquinolone for the first-line treatment of uncomplicated urinary tract infections (UTIs) in women.[1]
- Fosfomycin 3 g PO once
- Lower clinical and microbiologic success compared to nitrofurantoin TID for 5 days [2]
Women, Complicated
- Ciprofloxacin 500mg BID x10-14d, OR
- Cefpodoxime 200 mg BID x10-14d
Women, Concern for Urethritis
- Ceftriaxone 250mg IM x1 AND azithromycin 1gm PO x1 AND nitrofurantoin ER 100mg BID x5d, OR
- Levofloxacin 500mg QD x 14d (covers urinary pathogens, GC, and chlamydia)
- GC resistance to fluoroquinolones is increasing
Men
- Ciprofloxacin 500mg BID x10-14d, OR
- Cefpodoxime 200 mg BID x10-14d
Inpatient Options
- Ciprofloxacin 400mg IV q12hr, OR
- Ceftriaxone 1gm IV QD, OR
- Cefotaxime 1-2gm IV q8hr, OR
- Gentamicin 3mg/kg/day divided q8hr +/- ampicillin 1–2 gm q4hr, OR
- Piperacillin/Tazobactam 3.375 gm IV q6hr, OR
- Cefepime 2gm IV q8hr, OR
- Imipenem 500mg IV q8hr
- ↑ Choosing Wisely. American Urogynecologic Society. http://www.choosingwisely.org/societies/american-urogynecologic-society
- ↑ Huttner, A., Kowalczyk, A., Turjeman, A., Babich, T., Brossier, C., Eliakim-Raz, N., … Harbarth, S. (2018). Effect of 5-Day Nitrofurantoin vs Single-Dose Fosfomycin on Clinical Resolution of Uncomplicated Lower Urinary Tract Infection in Women: A Randomized Clinical Trial. JAMA: The Journal of the American Medical Association, 319(17), 1781–1789.