UTI Treatment Guidelines

Uncomplicated Cystitis

• The European Urology guidelines recommend fosfomycin trometamol 3 g single dose for uncomplicated cystitis in women 1
• The European Urology guidelines recommend nitrofurantoin 50-100 mg four times daily or 100 mg twice daily for 5 days for uncomplicated cystitis in women 1
• The European Urology guidelines recommend trimethoprim-sulfamethoxazole 160/800 mg twice daily for 3 days for uncomplicated cystitis in women 1
• The European Urology guidelines recommend trimethoprim-sulfamethoxazole 160/800 mg twice daily for 7 days for uncomplicated cystitis in men 1

Uncomplicated Pyelonephritis

• The European Urology guidelines recommend oral ciprofloxacin 500-750 mg twice daily for 7 days for uncomplicated pyelonephritis 2
• The European Urology guidelines recommend oral levofloxacin 750 mg once daily for 5 days for uncomplicated pyelonephritis 2
• The European Urology guidelines recommend trimethoprim-sulfamethoxazole 160/800 mg twice daily for 14 days for uncomplicated pyelonephritis 2

Complicated UTIs

• The European Urology guidelines recommend individualized duration of treatment based on severity and underlying complicating factors for complicated UTIs 2
• The European Urology guidelines recommend a typical duration of 7-14 days for most complicated UTIs 1

Treatment Failure

• The European Urology guidelines recommend obtaining urine culture and antimicrobial susceptibility testing for women whose symptoms do not resolve by end of treatment or recur within 2 weeks 1
• The European Urology guidelines recommend retreating with a 7-day regimen using a different antimicrobial class for women whose symptoms do not resolve by end of treatment or recur within 2 weeks 1

Agent-Specific Limitations

• The European Urology guidelines recommend that fluoroquinolones should only be used when local resistance is <10% 2
• The European Urology guidelines recommend that trimethoprim-sulfamethoxazole should not be used in the first or last trimester of pregnancy 1