cystitis

Uncomplicated UTI

  • etiology: E. coli, Klebsiella, staph sapro
    • enterococci and strep agalactiae (group B strep) often cause false positive result
  • empiric treatment: bactrim 3 days or macrobid 5 days
  • alternative:
    • augmentin 5-7 days
    • fosfomycin 3 gm 1 dose
    • cipro 3 days
    • cefdinir 3-7 days
  • ESBL e coli often susceptible to fosfomycin or ertapenem

Complicated UTI

  • pts: obstruction, reflux, azotemia, transplant, foley cather associated
  • etiology: enterobacter, pseudomonas, enterococcus, staph aureus (rare)
  • empiric therapy: ciprofloxacin or levofloxacin
    • high risk for MDR: zosyn, cefepime, ertapenem
  • duration of therapy: 7-14 days