Consider local resistance patterns (if >10-20% use a different agent)
Avoid use of fluoroquinolones for uncomplicated cystitis if possible
Consider phenazopyridine for dysuria symptoms
100-200mg TID after meals x 2 days for pain control (bladder analgesic)
Warn of discoloration of urine and tears. Don’t wear contact lens due to risk of staining.
100-200mg TID after meals x 2 days for pain control (bladder analgesic)
Warn of discoloration of urine and tears. Don’t wear contact lens due to risk of staining.
Symptoms >7days
Diabetes mellitus
Urinary tract infection in previous 4wk
Men
>65 years old
Women who use spermicides or diaphragm
Relapse
Pregnancy
Women, Uncomplicated
Nitrofurantoin ER 100mg BID x 5d, OR
TMP/SMX DS (160/800mg) 1 tab BID x 3d, OR
Cephalexin 250mg QID x 5d, OR
Ciprofloxacin 250mg BID x3d
Avoid using fluoroquinolone for the first-line treatment of uncomplicated urinary tract infections (UTIs) in women.
Fosfomycin 3 g PO once
Lower clinical and microbiologic success compared to nitrofurantoin TID for 5 days 
Avoid using fluoroquinolone for the first-line treatment of uncomplicated urinary tract infections (UTIs) in women.
Lower clinical and microbiologic success compared to nitrofurantoin TID for 5 days 
Women, Complicated
Ciprofloxacin 500mg BID x10-14d, OR
Cefpodoxime 200 mg BID x10-14d
Women, Concern for Urethritis
Ceftriaxone 250mg IM x1 AND azithromycin 1gm PO x1 AND nitrofurantoin ER 100mg BID x5d, OR
Levofloxacin 500mg QD x 14d (covers urinary pathogens, GC, and chlamydia)
GC resistance to fluoroquinolones is increasing
GC resistance to fluoroquinolones is increasing
Men
Ciprofloxacin 500mg BID x10-14d, OR
Cefpodoxime 200 mg BID x10-14d
Ciprofloxacin 400mg IV q12hr, OR
Ceftriaxone 1gm IV QD, OR
Cefotaxime 1-2gm IV q8hr, OR
Gentamicin 3mg/kg/day divided q8hr +/- ampicillin 1–2 gm q4hr, OR
Piperacillin/Tazobactam 3.375 gm IV q6hr, OR
Cefepime 2gm IV q8hr, OR
Imipenem 500mg IV q8hr
Acute cystitis
Pyelonephritis
Interstitial cystitis
Infected kidney stone
Pelvic origin
Pelvic inflammatory disease
Prostatitis
Ectopic