Urinary tract infections

Lower UTI (uncomplicated)

If treated for UTI in the last 6 months, check Microbiology history for suitable antibiotic choice

ORAL

NITROFURANTOIN 100mg MR BD or 50mg QDS (eGFR >45)

Or

TRIMETHOPRIM 200mg BD (eGFR >35)

Consider as an alternative FOSFOMYCIN (3g single dose) for women only

INTRAVENOUS

See upper UTI

Duration:  Females: 3-5 days  Males: 7 days

Upper UTI

ORAL

COTRIMOXAZOLE 960mg BD

Or (known renal impairment)

CO-AMOXICLAV 625mg TDS

Or (if neither of the above are suitable)

CIPROFLOXACIN 500mg BD -please review MHRA Safety Advice

INTRAVENOUS

AMOXICILLIN 1g TDS

Plus

GENTAMICIN Dose as per calculator

True penicillin allergy

GENTAMICIN (monotherapy) Dose as per calculator

Duration:  Oral: 7 days  IV: aim to convert to oral and complete 7 days total

If IV treatment is still needed after three days, convert GENTAMICIN to:

TEMOCILLIN 2g TDS

True penicillin allergy: Discuss with Microbiology

Catheter-associated UTI

Do not use dipsticks with catheter samples. Treat only if symptomatic

If possible remove catheter; if not, change 24-48h into treatment

Treat as for lower or upper UTI depending on clinical signs and symptoms.

Duration: 7 days (lower UTI only) or as per upper UTI