URO 1.4 UTI without systemic symptoms (Cystitis)

Recommendations

≥ 18 years
	Dosage	Remarks
1st choice	nitrofurantoin oral 100 mg twice daily or nitrofurantoin oral 50 mg four times daily	Nitrofurantoin 100 mg MGA Treatment duration for women: 5 days Treatment duration for men: 7 days Treatment duration for patients with diabetes: 7 days
2nd choice	fosfomycin oral 3 g	Single dose
3rd choice	trimethoprim oral 300 mg once daily	- Treatment duration for women: 3 days - Treatment duration for men: 7 days

≥ 18 years

Indications: During pregnancy
	Dosage	Remarks
	nitrofurantoin oral 100 mg twice daily for 5 days	Nitrofurantoin 100 mg MGA Up to 30 days before delivery
	amoxicillin + clavulanic acid oral 500/125 mg three times daily for 5 days	From 30 days before delivery

≥ 18 years

Indications: In patients with an indwelling catheter
	Dosage	Remarks
	nitrofurantoin oral 100 mg twice daily for 5 days	Nitrofurantoin 100 mg MGA As part of catheter replacement Adjust management based on culture results if necessary

≥ 18 years

Indications: Patients with diabetes
	Dosage	Remarks
	nitrofurantoin oral 100 mg twice daily for 7 days	Nitrofurantoin 100 mg MGA

Review urine cultures from the past 12 months to consider adjusting empirical therapy.

Adjust antibiotics based on culture results.

Replace catheter during therapy. For NSK or JJ catheters always consult a urologist.

Pregnant women:

check urine after treatment
if GBS is present in the urine culture (severe maternal colonisation) consult the obstetrician for prophylaxis during labour

In case of (suspected) allergy to penicillins and/or cephalosporins:

Consult the clinical microbiologist/infectious diseases specialist for an alternative regimen.