Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women

Publication Date: March 1, 2011

Key Points

Key Points

  • Preferred antibiotics for acute cystitis are nitrofurantoin, or trimethoprim-sulfamethoxazole (TMP-SMX) if local resistance rates are < 20%.
  • In patients suspected of pyelonephritis, a urine culture and susceptibility testing should always be performed.
  • Preferred antibiotics for outpatient pyelonephritis are a fluoroquinolone or TMP-SMX. Consider an initial single-dose IV ceftriaxone or an aminoglycoside if community resistance is > 10% or, for TMP-SMX, if susceptibility unknown.
  • Women with pyelonephritis requiring hospitalization should be initially treated with an IV antimicrobial regimen such as a fluoroquinolone, an aminoglycoside with or without ampicillin, an extended-spectrum cephalosporin or extended-spectrum penicillin with or without an aminoglycoside, or a carbapenem.

Selecting a Treatment Regimen

...electing a Treatment Regimen

...Uncomplicated Cystitis...

...toin monohydrate/macrocrystals 100 mg bid for...

...-SMX DS bid for 3 days is an appropriate choice fo...

...of 20% as the resistance prevalence at w...

In some countries and regions, trimetho...

...osfomycin tromethamine 3 g single-dose is an...

...m 400 mg bid for 3 to 7 days is an...

...ighly efficacious. ( A , I )659...

...a propensity for collateral damage and should b...

...ts including amoxicillin-clavulanat...

...tams, such as cephalexin, are less well studied...

...actams generally have inferior efficacy and more a...

...59

...or ampicillin should NOT be used for...


...Pyelonephritis...

...suspected of pyelonephritis, a urine culture an...

...cin 500 mg bid for 7 days with or wi...

...e-time IV agent is utilized, a long-act...

...itial one-time IV dose of a long-acting p...

...consolidated 24-hour dose of an aminoglycosid...

...ily oral fluoroquinolone, including c...

...m-sulfamethoxazole (TMP-SMX) bid for 14...

...n initial IV dose of a long-acting parenter...

...a consolidated 24-hour dose of an aminoglyco...

...nephritis requiring hospitalization should be i...


...ted Urinary Tract Infections...


...ntibiotics for Acute Uncomplicated CystitisHaving...