SandboxAB

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Acute Bacterial Uncomplicated Cystitis†
Preferred Regimen
Nitrofurantoin 100 mg po q12h×5 days
OR
TMP-SMX‡ 1 DS tab po q12h×3 days
OR
Fosfomycin 3 gm single dose
OR
Pivmecillinam♦ 400 mg bid×5 days
Alternative Regimen
Fluoroquinolones for 3 days
Ofloxacin 200–400 mg po bid.
Ciprofloxacin 250 mg bid po or Cipro XR 500 mg q24h
Levofloxacin 250–750 mg po q24

OR
β-lactam agents for 3-7 days
Amoxicillin-clavulanate 500/125 mg po tid or 875/125 mg po bid
Cefdinir 300 mg po q12h or 600 mg po q24
Cefaclor 250-500 mg po q8h
Cefpodoxime-proxetil 100-200 mg po q12h

Others(Cephalexin250-500 mg po q6h ) not studied well but effective.


† Acute uncomplicated cystitis: Premenopausal, nonpregnant women with no known urological abnormalities or comorbidities,postmenopausal women or well-controlled diabetes female patient.

‡Avoid if resistance prevalence is known to exceed 20% or if used for UTI in previous 3 months.

♦Pivmecillinam is available in some European countries, not licensed in US.




Fungal cystitis in the non-neutropenic patient
Candida
Fluconazole 200 mg PO/IV ×7-14 days
Alternative
Amphotericin B 0.3 - 0.6 mg/kg IV once daily×1-7 days