Treatment Plan

Treatment Plan

Uncomplicated UTI:

• Self-care if mild o Conservative measures: plenty of fluids, wipe front to back, don’t delay urination, and don’t wear occlusive underwear
• If no improvement in 48h:
  First line: nitrofurantoin/trimethoprim (3 days) Second line: pivmecillinam (3 days)

Pregnancy UTI:

• 7-day course
• First line: cefalexin/amoxicillin
• Avoid trimethoprim (teratogenic)
• Avoid nitrofurantoin in the third trimester

Recurrent UTI:

• MSU before antibiotics
• Postmenopausal: topical oestrogen
• Prophylaxis options: trimethoprim/nitrofurantoin/cefalexin/amoxicillin

Catheter-associated:

• Remove/replace the catheter before antibiotics
• Send MSU before treatment
• 7-day course: trimethoprim/nitrofurantoin/amoxicillin
• Second line: pivmecillinam

Prognosis

• Uncomplicated UTIs: self-limiting, resolves in a few days
• Complications can include:
  • Pyelonephritis
  • Renal abscess
  • Urosepsis
  • AKI