Lower UTI without sepsis - Female (not pregnant)

First Line

Trimethoprim 200 mg PO 12 hourly

or

*Nitrofurantoin MR 100mg PO 12 hourly

or

Pivmecillinam 400mg PO STAT, then 200mg 8 hourly (to a total course of 10 tablets)

 

* Nitrofurantoin is contra-indicated in patients with an eGFR < 45ml/min however a short course (3-7 days) may be used with caution in patients with an eGFR 30-44ml/min with suspected or proven multidrug resistant pathogens. Toxic plasma concentrations can occur particularly in the elderly causing adverse effects eg neuropathy, blood dyscrasias

Notes

Do not use amoxicillin alone unless supported by recent urine culture sensitivity

Ciprofloxacin should not be used first line for uncomplicated UTI 

Treatment duration: 3 days