Hospitalized Adults: Healthcare-Associated Urinary Tract Infection

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Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Healthcare-associated UTI

Enterobacteriaceae (e.g. E. coli)

P. aeruginosa (less common)

 

Ceftriaxone

1 g IV q24h

OR

Ertapenem 1g IV daily

OR

Piperacillin/tazobactamID-R: SFGH 4.5g IV q8h

For severe PCN allergy:

ONE OF:

Gentamicin

OR

Aztreonam ID-R: SFGH 

2 g IV q8h

BOTH WITH OR WITHOUT:

Vancomycin

Criteria: signs and symptoms compatible with a UTI, no other identified source of infection, & ≥ 1000 cfu of ≥ 1 bacterial species on urine culture.

Pyuria alone is not an indication for treatment.

A negative urinalysis suggests an alternative source of infection.

Remove catheter if possible.

Switch to oral therapy when susceptibilities known and patient stable.

7 days of therapy is recommend if patient has prompt resolution of symptoms