Table 2.
Treatment and prophylactic antimicrobial options for UTI
| Antibiotic | Dosage | Maximum daily dose | Comment |
|---|---|---|---|
| A. Upper UTI (pyelonephritis): oral | |||
| Amoxicillin/clavulanate | 40 mg/kg/dose 2× daily p.o. | 3 g | Based on amoxicillin component |
| Cefpodoxime | 4 mg/kg/dose 2× daily p.o. | 400 mg | Age ≥ 30 days |
| Cefuroxime | 15 mg/kg/dose 2× daily p.o. | 1 g | |
| Amoxicillin | 40 mg/kg/dose 2× daily p.o. | 3 g | |
| B. Upper UTI (pyelonephritis): intravenous | |||
| Amoxicillin | 25–50 mg/kg/dose 3–4× daily iv. | 12 g | |
| Gentamicin | 7.5 mg/kg/dose 1× daily i.v./i.m. | For neonates and preterms, also consult neonatal antimicrobial guidelines | |
| Amikacin | 15 mg/kg/dose 1× daily i.v./i.m. | 1.5 g | For neonates and preterms, also consult neonatal antimicrobial guidelines |
| Tobramycin | 4–6 mg/kg/dose 1× daily i.v./i.m. | 7.5 mg/kg | For neonates and preterms, also consult neonatal antimicrobial guidelines |
| Ceftriaxone | 50 mg/kg/dose 1× daily i.v./i.m. | 2 g | For neonates and preterms, also consult neonatal antimicrobial guidelines |
| Cefuroxime | 33 mg/kg/dose 3× daily i.v. / i.m. | 4.5 g | |
| Amoxicillin/clavulanate | 25–50 mg/kg/dose 3–4× daily iv. | 12 g | Based on amoxicillin component |
| C. Lower UTI (cystitis): oral | |||
| Trimethoprim-sulfamethoxazole | 3–5 mg/kg/dose 2× daily p.o. | 320 mg | Based on trimethoprim; age > 30 days; contraindicated in hyperbilirubinaemia |
| Amoxicillin | 25 mg/kg/dose 2× daily p.o. | 4 g | |
| Amoxicillin/clavulanate | 25 mg/kg/dose 2× daily p.o. | 4 g | Based on amoxicillin |
| Cefuroxime | 10–15 mg/kg/dose 2× daily p.o. | 1 g | |
| D. Antibiotic prophylaxis | |||
| Trimethoprim | 1.5 mg/kg/dose 2× daily or 2 mg/kg/dose 1× daily (evening) | 320 mg | Neonates and children: twice daily regimen for children still wearing diapers; Infectotrimet® suspension can be ordered by local pharmacy from neighboring countries. No Swissmedic application necessary. |
| Trimethoprim-sulfametoxazole | 1 mg/kg/dose 2× daily or 2 mg/kg/dose 1× daily (evening) | 320 mg | Age > 30 days; dose based on trimethoprim (TMP); twice daily regimen for children still wearing diapers. |
| Nitrofurantoin | 1 mg/kg/dose 2× daily or 2 mg/kg/dose 1× daily (evening) | 100 mg/dose | Age > 30 days |
| Amoxicillin | 10 mg/kg/dose 2× daily | Use for prophylaxis only for neonates (if trimethoprim not available) | |