Acute Uncomplicated Cystitis

Question 1

Non antibiotic treatment - 1

Answer 1

Phenazopyridine hydrochloride - unnecessary when using antibiotics

Question 2

Antibiotic treatment goal?

Answer 2

Achieving concentrations above MIC in the urine

Question 3

Antibiotic treatment 1st line - 3

Answer 3

• Nitrofurantoin (Macrodentin) for 5d- for cystitis only
• Fosfomycin once - for cystitis only
• Trimethoprim-sulfamethoxazole (Resprim) for 3d (resistance in Israel is high!)

Question 4

Antibiotic treatment 2nd line - 2

Answer 4

• Fluoroquinolone for 3d (resistance in the community is rising) - also conc in urine but saved for severe cases when 1st line is ineffective since it is quick to dev resistance
• Β lactam for 3-7d

Question 5

Response to treatment - 2

Answer 5

• Symptomatic relief should be achieved w/in 24h.
• If no response or relapse with treatment discontinuation Obtain urine culture – recheck species Consider upper UTI (pyelonephritis)