B-QuiCK: UTI
The diagnosis and management of symptomatic lower UTIs in adults
Table 1. Empiric antibiotic regimens for uncomplicated UTI in adults.
N.B. Treat for seven days in pregnant females and in all males, regardless of antibiotic choice.
| Antibiotic |
Dose |
First-line |
Nitrofurantoin*† |
Modified release (Macrobid): 100 mg, twice daily, for five days
Immediate release (Nifuran): 50 mg, four times daily, for five days |
Alternatives |
Cefalexin |
500 mg, twice daily, for three days |
Trimethoprim‡ |
300 mg, once daily, for three days |
* Contraindicated in patients with a creatine clearance < 60 mL/min due to the risk of peripheral neuropathy. Prescribe
nitrofurantoin by brand name to reduce errors as there are two different formulations. Nitrofurantoin is
not an appropriate first-line choice in patients with suspected pyelonephritis as it is associated with poor tissue penetration.
† Avoid after 36 weeks gestation in pregnant females
‡ Avoid in the first trimester of pregnancy