Template:Acute cystitis antibiotics: Difference between revisions

Latest revision as of 06:04, 20 January 2026

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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.

[1] Choosing Wisely. American Urogynecologic Society. http://www.choosingwisely.org/societies/american-urogynecologic-society

[2] 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.

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[2]

@@ Line 1: / Line 1: @@
-====Women, uncomplicated cystitis====
+<noinclude><languages/></noinclude>
-*Nonpregnant, few prior UTI episodes, symptoms <7d, no flank pain or fever
+<translate>
-#[[Nitrofurantoin]] ER 100mg BID x 5d OR
-#[[TMP/SMX]] DS (160/800mg) 1 tab BID x 3d OR
-#[[Cephalexin]] 250mg QID x 5d OR
-#[[Ciprofloxacin]] 250mg BID x3d
-====Women, complicated cystitis/pyelo====
+===Outpatient=== <!--T:1-->
-*Risks for complicated UTI or symptoms of pyelo
-#[[Ciprofloxacin]] 500mg BID x10-14d OR
-#[[Cefpodoxime]] 200 mg BID x10-14d
+<!--T:2-->
+'''Women, Uncomplicated'''
+*[[Special:MyLanguage/Nitrofurantoin|Nitrofurantoin]] ER 100mg BID x 5d, OR
+*[[Special:MyLanguage/TMP/SMX|TMP/SMX]] DS (160/800mg) 1 tab BID x 3d (Females) x7days (Males), OR
+*[[Special:MyLanguage/Cephalexin|Cephalexin]] 250mg QID x 5d, OR
+*[[Special:MyLanguage/Ciprofloxacin|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>
+*[[Special:MyLanguage/Fosfomycin|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'''
+*[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 500mg BID x10-14d, OR
+*[[Special:MyLanguage/Cefpodoxime|Cefpodoxime]] 200 mg BID x10-14d
-====Women, uncomplicated cystitis AND urethritis====
+<!--T:3-->
-#[[Ceftriaxone]] 250mg IM x1 AND azithromycin 1gm PO x1 AND nitrofurantoin ER 100mg BID x5d OR
+'''Women, Concern for [[Special:MyLanguage/Urethritis|Urethritis]]'''
-#[[Levofloxacin]] 500mg QD x 14d (covers UTI pathogens, GC, and chlam)
+*[[Special:MyLanguage/Ceftriaxone|Ceftriaxone]] 250mg IM x1 AND [[Special:MyLanguage/azithromycin|azithromycin]] 1gm PO x1 AND [[Special:MyLanguage/nitrofurantoin|nitrofurantoin]] ER 100mg BID x5d, OR
-##GC resistance to fluoroquinolones is increasing
+*[[Special:MyLanguage/Levofloxacin|Levofloxacin]] 500mg QD x 14d (covers urinary pathogens, [[Special:MyLanguage/GC|GC]], and [[Special:MyLanguage/chlamydia|chlamydia]])
+**[[Special:MyLanguage/GC|GC]] resistance to fluoroquinolones is increasing
-====Men, cystitis/pyelo====
+<!--T:4-->
-*Consider urethritis and [[prostatitis]]
+'''Men'''
-#[[Ciprofloxacin]] 500mg BID x10-14d OR
+*[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 500mg BID x10-14d, OR
-#[[Cefpodoxime]] 200 mg BID x10-14d
+*[[Special:MyLanguage/Cefpodoxime|Cefpodoxime]] 200 mg BID x10-14d
-====Inpatient Options====
-*[[Ciprofloxacin]] 400mg IV q12hr OR
+===Inpatient Options=== <!--T:5-->
-*[[Ceftriaxone]] 1gm IV QD OR
-*Cefotaxime 1-2gm IV q8hr OR
+<!--T:6-->
-*[[Gentamicin]] 3mg/kg/day divided q8hr +/- ampicillin 1–2 gm q4hr OR
+*[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 400mg IV q12hr, OR
-*[[Piperacillin/Tazobactam]] 3.375 gm IV q6hr OR
+*[[Special:MyLanguage/Ceftriaxone|Ceftriaxone]] 1gm IV QD, OR
-*[[Cefepime]] 2gm IV q8hr OR
+*[[Special:MyLanguage/Cefotaxime|Cefotaxime]] 1-2gm IV q8hr, OR
-*[[Imipenem]] 500mg IV q8hr
+*[[Special:MyLanguage/Gentamicin|Gentamicin]] 3mg/kg/day divided q8hr +/- ampicillin 1–2 gm q4hr, OR
+*[[Special:MyLanguage/Piperacillin/Tazobactam|Piperacillin/Tazobactam]] 3.375 gm IV q6hr, OR
+*[[Special:MyLanguage/Cefepime|Cefepime]] 2gm IV q8hr, OR
+*[[Special:MyLanguage/Imipenem|Imipenem]] 500mg IV q8hr
+</translate>