Table 1. Antibiotics for Acute Uncomplicated Cystitis
Drug and Dose
Nitrofurantoin
monohydrate/macrocrystals
100 mg bid for 5-7 days
Estimated
Clinical
Efficacy a,b,e
Estimated
Microbiological
Efficacy b,e
Common Side Effects
93% (84%-95%) 88% (86%-92%) Nausea, headache
Trimethoprim93% (90%-100%) 94% (91%-100%) Rash, urticaria, nausea,
sulfamethoxazole 160/800 mg
vomiting, hematologic
(TMP-SMX DS) bid for
3 days
Fosfomycin tromethamine
(Monurol ®)
3 g single-dose sachet
91%
Fluoroquinolones
(dose varies by agent)
3-day regimenc, e
90% (85%-98%) 91% (81%-98%) Nausea/vomiting,
diarrhea, headache,
drowsiness, insomnia
β-lactams
(dose varies by agent)
3-5 day regimend, e
89% (79%-98%) 82% (74%-98%) Diarrhea, nausea,
vomiting, rash, urticaria
a
80% (78%-83%) Diarrhea, nausea,
headache
Efficacy rates refer to cure rates on the visit closest to a 5-9 day period after treatment and are averages or
ranges calculated from clinical trials discussed in the text.
Estimated clinical efficacy and microbiological efficacy rates should not necessarily be compared across
agents since study design, efficacy definition, therapy duration, and other factors are heterogeneous.
Studies represent clinical trials published since publication of the 1999 Infectious Diseases Society
of America guidelines so as to represent efficacy rates that account for contemporary prevalence of
antibiotic-resistant uropathogens. Note that efficacy rates may vary geographically depending on local
patterns of antimicrobial resistance among uropathogens.
c
Fluoroquinolones data are compiled from regimens of ofloxacin, norfloxacin, and ciprofloxacin from the
referenced clinical trials and not other fluoroquinolones that are no longer commercially available.
d
β-Lactams data cited are derived from clinical trials examining second- and third-generation
cephalosporins and amoxicillin/clavulanate.
e
See full text guidelines for details. http://cid.oxfordjournals.org/content/52/5/e103.full.pdf+html
b
