Uncomplicated Cystitis, Women

Diagnosis Common Pathogens Drug(s) of First Choice Alternative Drug(s) Comments Expected Duration

Uncomplicated Cystitis, Women

Enterobacteriaceae (E. coli)

Staph. saprophyticus (Coagulase negative staphylococcus) (4%)

Trimethoprim/ Sulfamethoxazole 1 DS PO BID x 3 days (if no previous antibiotic therapy)

OR

Nitrofurantoin 100 mg PO BID x 5 days (avoid if CrCl < 30 mL/min)

Cephalexin 500 mg PO BID x 5-7 days

Reserve for patients at highest risk of failure (selection for resistant isolates):

Ciprofloxacin 500mg PO q12h x 3 days

Asymptomatic bacteriuria and/or pyuria are not indications for treatment

Exceptions: pregnant women, patients having traumatic urologic procedures, ANC < 500, recent renal transplant (3 months)

IDSA guidelines state Trimethoprim/ Sulfamethoxazole is appropriate if resistance rates do not exceed 20%

In patients with recurrent UTIs, review recent microbiology to help determine empirical therapy

3-7 days depending on antibiotic chosen

Clinical Infectious Diseases, Volume 52, Issue 5, 1 March 2011, Pages e103–e120, https://doi.org/10.1093/cid/ciq257