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Table 2. IOU Consensus Recommendations for Empirical Treatment
of Acute Simple (Uncomplicated) Cystitis in Nursing Home
Residents
Empirical Initial Treatment
Nitrofurantoin in those with eCrCl >30 mL/min
OR
Trimethoprim-sulfamethoxazole in those with eCrCl ≥15 mL/min
OR
Ciprofloxacin or fosfomycin ONLY IF eCrCl <15 mL/min
Recommended Dosing for Different Levels of Renal Function
Estimated
eCrCl Maximum Dosing for Anti-Infective
>30 mL/min Nitrofurantoin 100 mg twice a day
OR
Trimethoprim-sulfamethoxazole 160 mg/800 mg
(one double strength) twice a day
15–30 mL/min Trimethoprim-sulfamethoxazole 80 mg/400 mg
(one single strength) twice a day
AVOID ➞ Nitrofurantoin
<15 mL/min Cirprofloxacin 250 mg twice a day
Fosfomycin 3 gm once
AVOID ➞ Nitrofurantoin & Trimethroprim-sulfamethoxazole
Drug-Drug Interactions to Avoid
Interacting Anti-Infective Affected Medications
Ciprofloxacin eophylline, Tizanidine, Warfarin
Trimethoprim-sulfamethoxazole Methotrexate, Phenytoin, Procainaminde,
Warafrin
Duration of Anti-Infective Treatment Except for Fosfomycin
Sex Number of Days
Women 3
Men 7
Source: Hanlon JT et al. e IOU Consensus Recommendations for Empirical erapy of Cystitis in
Nursing Home Residents. J Am Geriatr Soc. 2019 Mar;67(3):539-545.
