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Home > Adult Outpatients: Urinary Tract Infections: Cystitis

Adult Outpatients: Urinary Tract Infections: Cystitis

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.

Drug(s) of First
Diagnosis Common Pathogens Alternative Drug(s) Comments
Choice
 Reserve for patients at
highest risk of failure
(selection for resistant
isolates):

Ciprofloxacin [1] 500 IDSA guidelines state

mg PO BID x 3 days Trimethoprim/
Nitrofurantoin 100 mg Sulfamethoxazole is
PO BID x 5-7 days ? OR appropriate if resistance
contraindicated in renal rates do not exceed 20%.
insufficiency (CrCl < 60 Levofloxacin [1] 500
ml/min) mg PO daily x 3 days Susceptibility data:
Enterobacteriaceae (E.
OR UCSF [2]
Uncomplicated coli)
Cystitis Reserve for patients
TMP/SMX [1] 1 DS tablet SFGH [3]
S. saprophyticus with history of resistant
PO BID x 3 days (if no
Women (Coagulase negative organisms or
previous antibiotic VASF [4]
staphylococcus) (4%) therapeutic failure (less
therapy)
effective): Nitrofurantoin is
OR contraindicated in renal
Cephalexin 500 mg insufficiency (CrCl <60
Fosfomycin 3 g PO x1 PO QID x 7 days ml/min).
dose
OR Fosfomycin is not on the
SFGH formulary.
Cefpodoxime 200 mg
PO BID x 7 days
Recurrent Prophylaxis:
Cystitis
Either self administration
Enterobacteriaceae (E.
Women if symptoms occur or
coli) Antibiotic choice
prophylactic post-coital should be based on
(3 or more S. saprophyticus antibiotics susceptibility results of
episodes/year) (Coagulase negative previous culture.
staphylococcus) (4%)
Post menopausal: topical
estrogen

Pyuria is not an indication

for treatment.
E.coli
Asymptomatic
Klebsiella No treatment required*
bacteriuria *Exceptions: pregnant
Enterococcus women, patients having
traumatic urologic
procedures.

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Source URL: https://idmp.ucsf.edu/adult-outpatients-urinary-tract-infections-cystitis?mag_q=printpdf/461

Links
[1] http://idmp.ucsf.edu/adult-antimicrobial-dosing-non-dialysis
[2] http://idmp.ucsf.edu/antimicrobial-susceptibility-ucsf-medical-center
[3] http://idmp.ucsf.edu/antimicrobial-susceptibility-san-francisco-general-hospital
[4] http://idmp.ucsf.edu/antimicrobial-susceptibility-veterans-affairs-medical-center-san-francisco