UTI in Pregnancy

UTI in pregnancy

PHE URINE

CKS

UKtis

Send MSU for culture and start antibiotics in all with significant positive culture, even if asymptomatic. 

Short-term use of nitrofurantoin in pregnancy is unlikely to cause problems to the foetus.

Avoid trimethoprim if low folate status or on folate antagonist (eg antiepileptic or proguanil).

First linenitrofurantoin

(avoid if near term – risk of neonatal haemolysis)

100mg MR bd

7 days

IF susceptible, amoxicillin

500mg TDS

7 days

Second linetrimethoprim

Give folate 5mg daily if 1st trimester

200mg BD (off-label)

7 days

Third line: cefalexin

500mg BD

7 days