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Urinary Tract Infection
EM Notes
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PO Antibiotics for UTI
| Drug | Mechanism | Dosing (5 days) |
|---|---|---|
| Nitrofurantoin monohydrate/ macrocrystals (Macrobid) | reactive intermediates inactivate/alter bacterial ribosomal proteins | 100mg BID x 5 days (women) 7d for men |
| Trimethoprim-sulfamethoxazole (Bactrim) | interferes with purine and therefore DNA synthesis | DS tablet (160/800 mg) twice daily for 3 days |
| Fosfomycin | inhibits synthesis of peptidoglycan by blocking formation of N-acetylmuramic acid | 3 g as a single dose |
| Pivmecillinam | binds and inactivates penicillin-binding protein 2 (PBP 2) | 400 mg orally twice daily for 5-7 days |
| Levaquin | inhibits bacterial topoisomerase IV and DNA gyrase |
(uUTI) 250mg for 3 days (cUTI) 750 mg for 5 days |
| Ciprofloxacin | 250 mg every 12 hours for 3 days | |
| Cephalexin | binds and inactivates PBPs | 500mg BID for 5-7 days |
uUTI = uncomplicated UTI, cUTI=complicated UTI
Lower UTI in pregnancy:
- Nitrofurantoin (Macrobid): 100 mg PO b.i.d. × 7 days (5)
- Cephalexin (Keflex): 500 mg PO b.i.d. × 7 days
UTI during pregnancy always requires culture/sensitivity and usually requires a 7–14-day treatment.