Simple Cystitis

  • 1st line
    • Nitrofurantoin (Macrobid) 100mg PO BID x 5 days
      • Avoid use of Macrobid in pts with poor renal fxn (CRCL < 30 mL/min)
    • Cephalexin (Keflex) 1000mg PO TID x 3-5 days
  • 2nd line
    • Fosfomyin 3g PO x 1

Cipro 250mg PO BID x 3 days

Complicated Cystitis

  • Male, GU devices, urinary obstruction, diabetic or immunocompromised
  • 1stline
    • Cephalexin (Keflex) 1000mg PO TID x 5-7 days
    • Cefuroxime (Ceftin) 250mg PO BID x 5-7 days
    • Augmentin 875mg PO BID x 5-7 days
  • 2ndline
    • Ciprofloxacin 500mg PO BID x 3-5 days
  • 3rdline
    • Bactrim DS 1 PO BID x 5-7 days

 

 

Pyelonephritis – uncomplicated
Discharge abx

  • 1stline
    • Cephalexin 1000mg PO TID x 7 days
    • Cefuroxime (Ceftin) 500mg PO BID x 7 days
    • Augmentin 875mg PO BID x 7 days
  • 2ndline
    • Cipro 500mg PO BID x 5-7 days
  • 3rdline
    • Bactrim DS 1 PO BID x 7 days

 

Asymptomatic bacteriuria

  • Following are NOT indications for treatment of asymptomatic bacteriuria
    • DM / Immunocompromized / Elderly / Foley / Male / SNF
  • Asymptomatic bacteriuria in Pregnancy
    • 1st line: Cephalexin (Keflex) 500mg PO QID x 7 days
    • 2nd line: Cefuroxime 250mg PO BID x 7 days OR Nitrofurantoin 100mg PO BID x 7 days
      • Cation Nitrofurantoin near term, G6PD deficiency (rare) or renal failure
    • 3rd line: Bactrim DS 1 PO BID x 3 days (2nd/3rd trimesters preferred)
      • Caution use of Bactrim in 1st trimester