Table 1.

Antibiotic treatment of urinary tract infection during pregnancy

	Oral agent	Intravenous agent
Simple UTI (cystitis) with non ESBL producing Gram negatives	See your local guidelines •Cephalexin •Amoxicillin (better for GBS, few coliforms covered) •Nitrofurantoin •Trimethoprim (not in first trimester)	N/A
Simple UTI (cystitis) with ESBL producing Gram negatives	•Nitrofurantoin •Fosfomycin •Pivmecillinam Note nitrofurantoin and fosfomycin have no upper tract activity	N/A
Complex UTI (pyelonephritis)	N/A	•piperacillin-tazobactam (Tazocin) •carbapenem
Complex UTI (history of, or suspected, ESBL producing organism)	N/A	Carbapenem (e.g. meropenem) then consider prophylaxis – e.g. nitrofurantoin
Severe sepsis and pyelonephritis	N/A	If no previous gentamicin resistant organisms, a stat dose of gentamicin (3 mg/kg or see your local policy) plus piperacillin-tazobactam