Table 5.
Treatment Options in the United States for Uncomplicated UTI in the Outpatient Setting
| Antibiotic | Dosage for Normal Renal Functiona | Precautions | Study Type | Participant Characteristics | |
|---|---|---|---|---|---|
| Mean Age, (Range) y | Sex | ||||
| Nitrofurantoin | 100 mg twice daily for 3–5 days | Avoid if pyelonephritis is suspected51 | Prospective, randomized, double-blind, 3-group comparative57 | 34 (18–85) | Women only |
| Prospective, randomized, double-masked comparative58 | Nitrofurantoin: 33 (15–92) fosfomycin: 33 (16–80) |
Women only | |||
| Trimethoprim-sulfamethoxazole | One 160 mg-800 mg tablet twice daily for 3 days | Hemorrhage while undergoing warfarin therapy59; hyperkalemia while taking angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or spirinolactone60,61 | Population-based, nested case-control59 | 80 (74–85) | Men 53%, women 47% |
| Population-based, nested case-control study60 | Case group 82 control group 81 (75–87) |
Men 39%, women 61% |
|||
| Population-based, nested case-control61 | Case group 82 control group 81 (75–87) |
Men 31%, women 69% |
|||
| Prospective, randomized, comparative62 | Cefpodoxime: 44 (29–59), trimethoprim-sulfamethoxazole: median 42 (26–58) | Women only | |||
| Ciprofloxacin | 250 mg twice daily for 3 days | High rates of community-acquired isolates with resistance | Prospective, randomized, double-blind63 | 3-day group: 78.8 (SD 7.6) 7-day group: 78.6 (SD 7.3) |
Women only |
| Prospective, randomized, double-blind, 3-group comparative57 | 34 (18–85) | Women only | |||
| Fosfomycin trometamol | 3 gm daily for 1 day | Avoid if pyelonephritis is suspected51 | Prospective, randomized, double-masked comparative58 | Fosfomycin: 33 (16–80) nitrofurantoin: 33 (15–92) |
Women only |
| Cefpodoxime | 100 mg twice daily for 3 days | Higher failure rates for UTI with β-lactam antibiotics64 | Prospective, randomized, comparative62 | Cefpodoxime: 44 (29–59) trimethoprim-sulfamethoxazole: median 42 (26–58) |
Women only |
| Amoxicillin-clavulanate | 875 mg twice daily for 3 days | Higher failure rates for UTI with β-lactam antibiotics64 | Case-control64 | Age >60: case group 63% control group 35% |
Case group: women 77%, men 23%; control group: women 61%, men 39% |
| Gentamicin | 5 mg/kg once daily for 3 days | Need outpatient parenteral antibiotic therapy; reserve for isolates with no oral alternative | Prospective, randomized, comparative trial65 | Once daily: 53 (22–80) 3 × daily: 40 (20–74) | Women 86%, men 14% |
| Ertapenem | 1 gm daily intravenously for 3 days | Need outpatient parenteral antibiotic therapy; reserve for extended spectrum β-lactamases isolates56 | Retrospective, descriptive56 | 58 (32–71) | Men 55%, women 45% |
a
Dosage for normal renal function indicates a creatinine clearance of more than 60 mL/min/1.73 m2.