URO 1.2 UTI with systemic symptoms

Empirical treatment with ciprofloxacin PO can be considered if hospitalisation is not required or in case of anaphylaxis to beta-lactams

For (suspected) acute prostatitis prefer treatment with ciprofloxacin or cotrimoxazole

For sepsis see URO 1.1 Urosepsis | Radboud UMC (antibiotica.app)

When switching to oral agents guided by cultures: beta-lactam or cotrimoxazole: 10 days**; ciprofloxacin: 7 days

**If a shorter treatment is desired (e.g. adverse effects, interactions) a 7-day course may be considered, provided clinical condition is good and no fever >48 h

For sepsis see URO 1.1 Urosepsis | Radboud UMC (antibiotica.app)

When group B streptococcus is cultured there is an indication for antibiotic prophylaxis around delivery; consult the gynaecologist.

Treatment duration 10–14 days

If catheter <10 days in place follow the recommendations for patients without a catheter

If catheter >10 days in place

or possibly amoxicillin/clavulanic acid + amikacin

As per recommendations for patients without diabetes

Consult the nephrologist

>3 months after transplant: as per recommendations for patients without a kidney transplant

Consult the nephrologist

<3 months after transplant: consider coverage for enterococci and Pseudomonas (amoxicillin 1 g, 4 times daily + ceftazidime 2 g, 3 times daily OR ciprofloxacin 400 mg, twice daily; note: adjust dosages to renal function)

In suspected infected renal cyst: obtain cultures, preferably ciprofloxacin 400 mg twice daily IV or 500 mg twice daily PO for 4–6 weeks

Drainage is indicated for cysts > 5 cm.

See algorithm Swab guideline page 71