Treatment Plan

Treatment Plan

Conservative measures: plenty of fluids, wipe front to back, don’t delay urination and don’t wear occlusive underwear

Primary treatment:

• A 7-day course of:
  Trimethoprim
  Nitrofurantoin
  Amoxicillin
• Second line: o Pivmecillinam for 7 days
• Follow-up:
  • Review within 48-72 hours
• Recurrent UTIs (2+ in 6 months or 3+ in 12 months):
  • Treat acute episodes o Culture before antibiotics o    Consider specialist referral
  • Prophylactic options: trimethoprim 100mg ON, nitrofurantoin 50-100mg ON, amoxicillin 250mg ON, cefalexin 125mg ON

Referrals

• 2-week wait referral criteria:
  • Age >45 with unexplained visible haematuria without UTI, OR recurrent unexplained visible haematuria post-UTI treatment
  • Age >60 with unexplained non-visible haematuria plus dysuria/raised WCC
• Routine:
  • Ongoing symptoms despite treatment
  • Recurrent UTIs: ≥2 episodes in 6 months / ≥3 episodes in 12 months)