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Urinary tract infections

Urinary Tract Infections - UTI
Urinary tract infections Possible therapeutic alternatives
UTI: uncomplicated cystitis - urethritis Common pathogens
Bactrim DS orally twice daily for 3 days OR
Ciprofloxacin 250mg orally twice daily for 3 days
OR
Norfloxacin 400mg orally twice daily for 3 days
OR
 Ofloxacin 200mg orally twice daily for 3 days  OR
 Levofloxacin 250mg orally once daily for 3 days. OR
Augmentin 875/125 mg orally twice daily or  500/125mg three times daily
OR
Nitrofurantoin 100 mg po bid x 5 days
Recurrent cystitis(> 3 episodes per year) Common pathogens
Treat infection with one of the regimens above, then start long term maintenance therapy with Bactrim single-strength one tablet once daily or 3 times/week.
Complicated UTI: catheter in place, obstruction etc. Common pathogens
Therapy based on culture results
Ciprofloxacin 200-400mg IV every 12 hours or Levofloxacin 250 to 500mg IV qd  OR
Piperacillin-tazobactam 3.375 grams IV every 6 hours   OR
[Ampicillin 1 gram IV every 6 hours + Gentamicin IV]  OR
Imipenem 500mg IV  q6h
Gonococcal urethritis Neisseria gonorrhoeae
Cefixime 400 mg PO x 1 PLUS [ Azithromycin 1 g PO x 1 OR Doxycycline 100 mg PO bid x 7 days if chlamydia infection has not been ruled out]
Ceftriaxone 125 mg IM x 1  PLUS  [Azithromycin 1 g PO x 1 OR Doxycycline 100 mg PO bid x 7 days if chlamydia infection has not been ruled out]
non-gonococcal urethritis Chlamydia trachomatis
Azithromycin 1 g PO x 1
Doxycycline 100 mg PO bid x 7d
Recurrent or persistent urethritis Common pathogens
Metronidazole 2 grams po once + Erythromycin base 500 mg PO qid x 7 days
Metronidazole 2 grams PO once + erythromycin ethylsuccinate 800 mg PO qid x 7 days

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Acute cystitis (Bladder infection) Cross-section
cystitis
Urinary tract infections

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