Selecting a Treatment Regimen
Uncomplicated Urinary Tract Infections
Acute Uncomplicated
Cystitis
Acute Pyelonephritis
Urine C&S
Nitrofurantoin
monohydrate/
macrocrystals
100 mg bid x 5 d
OR
TMP-SMX DS bid x 3 d
Women NOT requiring
hospitalization
Women requiring
hospitalization
OR
Fosfomycin 3 g once
OR
If preferred agents
cannot be used
amoxicillin-clavulanate,
cefdinir, cefaclor, or
cefpodoxime-proxetil
x 3-7 d or
fluoroquinolone x 3 d
Oral ciprofloxacin
500 mg bid x 7 d
*†
OR
Ciprofloxacin ER
1000 mg daily x 7 d
OR levofloxacin
750 mg daily x 5 d
†
OR
†
Oral TMP-SMX DS
160/800 mg bid x 14 d
*
IV fluoroquinolone
OR
an aminoglycoside
with or without
ampicillin
OR
an extended-spectrum
cephalosporin or an
extended-spectrum
penicillin with
or without an
aminoglycoside
OR
a carbapenem
OR
Oral β-lactam (less effective) plus
initial IV ceftriaxone 1 g
OR IV 24-hour dose of aminoglycoside
* Choice depends on local resistance patterns and patient factors (history of resistant organisms or drug
allergies). If susceptibility of the infecting pathogen is not known, start with broader-spectrum regimens
and tailor down based on culture results.
†
WITH OR WITHOUT initial IV ciprofloxacin 400 mg OR initial IV ceftriaxone 1 g OR initial IV
24-hour dose of aminoglycoside
NOTE: The green boxes are preferred regimens.
