Genital and Urinary Tract infections

Duration

Treatment duration =  3 days (7 days in pregnancy and men )

Pregnancy – Avoid Trimethoprim 1st trimester and Nitrofurantoin 3rd trimester.

Lower UTI in all patients

Trimethoprim 200mg PO 12 hourly or

Nitrofurantion 100mg PO MR BD  

MSSU must be done. Consider delaying antibiotic treatment pending culture. Reassess once microbiology available.

Complicated UTI

UTI + sepsis or Pyelonephritis + / - sepsis (treat for 7-14 days depending on severity of infection and clinical response)

Amoxicillin 1g IV 8 hourly + Gentamicin

Step down to Co-amoxiclav 625mg po 8 hourly (375mg if low body weight)

Allergy: Ciprofloxacin 400mg IV 12 hourly + Gentamicin IV

Step down to Ciprofloxacin PO 500 - 750mg 12 hourly.

If penicillin allergy seek advice for Microbiologist.

Pyelonephritis in pregnancy

Co-amoxiclav 625mg 8 hourly (375mg if low body weight)

Treatment duration 14 days

If Penicillin allergy seek advice from Microbiologist

Urinary catheter sepsis: Change catheter after 24 – 48 hours of treatment.

Amoxicillin IV 1g 8 hourly +

Gentamicin IV step  down to Co-amoxiclav 625mg 8 hourly (375mg if low body weight)

Allergy: Ciprofloxacin 400mg IV 12 hourly + Gentamicin

Step down to :Ciprofloxacin PO 500 – 750mg 12 hourly 

Treatment duration = 5 days, guided by clinical response

If gram negative organism in blood culture Treatment duration = 7 days.

Acute Prostatitis

Ciprofloxacin PO 500mg 12 hourly

4 weeks of treatment may prevent chronic infection

Epididymo-orchitis

Ofloxacin 400mg PO daily 14 – 21 days

Epididymo-orchitis is often associated with Chlamydia infection- refer patient to GU medicine.