Genital and Urinary Tract infections
Treatment duration = 3 days (7 days in pregnancy and men )
Pregnancy – Avoid Trimethoprim 1st trimester and Nitrofurantoin 3rd trimester.
Trimethoprim 200mg PO 12 hourly or
Nitrofurantion 100mg PO MR BD
MSSU must be done. Consider delaying antibiotic treatment pending culture. Reassess once microbiology available.
UTI + sepsis or Pyelonephritis + / - sepsis (treat for 7-14 days depending on severity of infection and clinical response)
Amoxicillin 1g IV 8 hourly + Gentamicin
Step down to Co-amoxiclav 625mg po 8 hourly (375mg if low body weight)
Allergy: Ciprofloxacin 400mg IV 12 hourly + Gentamicin IV
Step down to Ciprofloxacin PO 500 - 750mg 12 hourly.
If penicillin allergy seek advice for Microbiologist.
Co-amoxiclav 625mg 8 hourly (375mg if low body weight)
Treatment duration 14 days
If Penicillin allergy seek advice from Microbiologist
Amoxicillin IV 1g 8 hourly +
Gentamicin IV step down to Co-amoxiclav 625mg 8 hourly (375mg if low body weight)
Allergy: Ciprofloxacin 400mg IV 12 hourly + Gentamicin
Step down to :Ciprofloxacin PO 500 – 750mg 12 hourly
Treatment duration = 5 days, guided by clinical response
If gram negative organism in blood culture Treatment duration = 7 days.
Ciprofloxacin PO 500mg 12 hourly
4 weeks of treatment may prevent chronic infection
Ofloxacin 400mg PO daily 14 – 21 days
Epididymo-orchitis is often associated with Chlamydia infection- refer patient to GU medicine.