UBC Faculty Research and Publications

Empiric Antibiotic Therapy for Uncomplicated Lower Urinary Tract Infections University of British Columbia. Therapeutics Initiative


Background: Therapeutics Letter 135 discusses antimicrobial best practices for treating uncomplicated UTIs in British Columbia (BC), Canada. Uncomplicated lower urinary tract infections (UTIs) are common and can be treated with empiric antibiotic therapy. However, antibiotic use should take into account local patterns of bacterial resistance. Conclusions: Urine dipstick/urinalysis and/or urine cultures are not recommended for diagnosing most uncomplicated lower urinary tract infections. Empiric prescription of nitrofurantoin for 5 to 7 days is recommended. The British Columbia Centre for Disease Control recommends one oral dose of fosfomycin 3 g when CrCl is ≤ 30mL/min or when there is allergy/intolerance to nitrofurantoin. TMP-SMX, fluoroquinolones, and beta-lactams are unsuitable for empiric therapy in BC due to bacterial resistance.

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