1) Eradicate causative organism

2) Prevent complications and recurrence of infection

Treat for 1-7 days (3 days is optimal)

Treat empirically (without C&S)

Treat 2-4 weeks (6 weeks if prostate is involved)

Perform Gram stain, C&S, and treat empirically until results return 

-most commonly caused by E. Coli (85 %), Klebsiella Pneumoniae, Proteus Mirabilis, Enterococcus spp.

-Treat empirically with broad spectrum treatment

-Tx with single dose or 3-7 day tx (3 d is optimal)

-perform gram stain

-if + cocci: S. fecalis; use Ampicillin

-treat empirically until C&S with FQ or B-Lactam + Aminoglycoside 

-treat for 14 d

-If inpatient tx with IV antimicrobials and IV fluids

-assoc. with fetal effects

-asymptomatic can progress to pyelonephritis (so ALWAYS tx!)

-screen for bacteriuria in pregrnancy

1st line tx: B-Lactams (Amoxicillin or Amoxicillin/Clavulanate (Augmentin) if increased resistance to Amoxicillin or Cephalosporins

-Sulfonamides (NOT in 3rd trimester: neonate hyperbilirubinemia)

NO Tetracyclines or FQ's (cause joint/ligament malformation) in PREGNANCY

f/u urine culture 1-2w after therapy completed 

-Common occurence

-Asymptomatic: remove catheter

-Symptomatic: remove catheter (if you can't remove catheter, change to new cath) and antimicrobials 

-most likely structural or functional abnl

-Tx like COMPLICATED UTI

-tx for 2 weeks; longer if prostate involved 

1 SS prophylactic therapy 

Sulfamethoxazole/Trimethoprim tab or Nitrofurantoin (Macrobid) post-intercourse

-instruct pt to void after intercourse

if relapse after short course therapy, 14 day tx 

-acute or chronic

dx with prostatic secretions and urine

-most common org is e.coli and other gram _

tx: TMP/SMX (Bactrim)

-FQ: ciprofloxacin, levofloxacin

acute: tx for 4 weeks

chronic: 6-12 weeks 

-prepubertal: Coliform bact (E.Coli) tx with sulfamethoxale/trimethoprim (Bactrim)

-Young adult to middle age: C. trachomatis, N. gonorrhoeae tx with Ceftriaxone (Rocephin) and Azithromycin both for 1 day or Doxycycline for 7 d 

-Older males-coliform bact (E. coli) tx with Bactrim 

caused by C. trachomatis and N. gonorrhoeae

tx with ceftriaxone % azithromycin (or doxycycline)

-TMP/SMX (Bactrim DS, Septra DS) 2 DS as single dose or 1 DS tab BID 3-7d; AVOID in Sulfa allergy pts, some R

-FQ; not much R, Cipro for 3-7 d (cheap), levofloxacin (Levaquin) X 3-7 d

-B-lactams: amoxicillin 1 high dose or 3  smaller doses; amoxicillin/caluvulanate (Augmentin) X 3d; cephalosporins (not as good as Augmentin)

-TMP/SMX (Bactrim, Septra DS) for 7-14 d 

-FQ: CIpro or Levofloxacin (Levaquin) for 7-14 d

-Amoxicillin/Clavulanate for 7-14 d

nitrofurantoin qday for 6 mo

TMP/SMX qday for 6 mo 

TMP/SMX (Bactrim, Septra DS) 1 tab BID X 14 d

FQ: Cipro BID X 14d or Levofloxacin (Levaquin BID X 14 d

amoxicillin/clavulanate TID X 14 d 

Phenazopyridine (Pyridium, AZO-Gesic, AZO-Standard, and Uristat)

-use with antimicrobial

AE: red-orange discoloration of urine, abdominal cramping, HA< hepatitis, acute renal failure, hemolytic anemia