Lower UTI without sepsis - Female (not pregnant)

First Line

Important: Therapy

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)

 

Notes:

* 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

Important: 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