Uncomplicated

- Pretreatment urine cultures recommended. Tailor antibiotics to C&S results. Do NOT use nitrofurantoin or fosfomycin as these are not systemically active.

 
Usual Pathogens

E. coli
Other Enterobacterales
S. saprophyticus

Outpatient - initial parenteral dose

Empiric Therapy Dose Duration
Ceftriaxone 1-2g IV/IM single dose
or    
Gentamicin 5-7mg/kg IV/IM single dose
then    

Oral therapy

Empiric Therapy Dose Duration
Cefixime 400mg PO daily 7-10 days
or    
Amoxicillin-clavulanate 875mg PO bid 7-10 days
or    
Ciprofloxacin 500mg PO bid or 7 days
  XL 1g PO daily 7 days
or    
TMP/SMX 1DS tab PO bid 7-10 days

ER/Hospitalized/Septic

Empiric Therapy Dose Duration
Ceftriaxone 1-2g IV q24h 7 days
or    
Gentamicin 5-7mg/kg IV q24h 7 days