Urinary Tract Infections

Urinary Tract Infections - UTI

Urinary tract infections

Possible therapeutic alternatives

UTI: uncomplicated cystitis - urethritis

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

Images

Acute cystitis (Bladder infection) Cross-section