Cephalexin for Uncomplicated Urinary Tract Infections

Position in Treatment Guidelines

• The European Association of Urology guidelines recommend oral cephalosporins like cefpodoxime and ceftibuten for pyelonephritis, and first-line agents typically include nitrofurantoin, trimethoprim-sulfamethoxazole, or fosfomycin, with fluoroquinolones reserved for more severe cases 1, 2
• Local resistance patterns should guide empiric therapy decisions, and cephalexin should not be used empirically if local E. coli resistance to cephalosporins is high 1, 2

Monitoring and Follow-up

• If symptoms do not improve within 48-72 hours, reevaluation is necessary to consider alternative diagnoses or resistant organisms 3