UTI

First Line

until 34 weeks 

Nitrofurantoin MR 100mg PO 12 hourly

after 14 weeks

Trimethoprim 200mg PO 12 hourly

 

2nd line:  

Cefalexin 500mg PO 12 hourly

or Amoxicillin 500mg PO 8 hourly (if sensitive on recent urine culture)

 

Third line (if reported sensitive on urine culture report and no option above suitable)

Cefuroxime 250mg PO 12 hourly

 

If escalation or severe infection / sepsis:

Co-amoxiclav 1.2g IV 8 hourly +/- Gentamicin IV as per protocol

Penicillin Allergy

until 34 weeks 

Nitrofurnatoin MR 100mg PO 12 hourly

after 14 weeks

Trimethoprim 200mg PO 12 hourly

 

If escalation or severe infection / sepsis:

Vancomycin IV + Gentamicin IV as per protocol

Cefalexin or Cefuroxime may be used with caution if there is history of mild penicillin allergy only (e.g. rash)

Notes

Send urine for culture prior to starting antibiotics

Send blood culture in severe infection / sepsis. 

 

Check previous microbiology results before prescribing an antibiotic.

 

Oral switch guidance for empirical IV recommendations

Review culture results first. If no positive microbiology results to guide:

Preferred regime - Co-amoxiclav 625mg PO 8 hourly +/-  Erythromycin 500mg PO 6 hourly

Alternative - Cefuroxime 500mg PO 12 hourly +/- Erythromycin 500mg PO 6 hourly