Complicated Cystitis

ONLY if CrCl ≥30 mL/min

• Avoid if prior urinary culture with SMX/TMP-resistant bacteria or if used within 12 months

• Can be used in patients with decreased renal function:

• If CrCl <30 mL/min, reduce dose to 1 SS PO Q12h

• Use with caution in pregnant females

Fluoroquinolones are considered only a last resort for patients with cystitis in the absence of risk factors for fluoroquinolone resistance

Non-β-lactam antibiotics often retain activity against ESBL-producing Enterobacteriaceae if not previously used

Only indicated for symptomatic patients. Growth of VRE in a urine culture often indicates urinary colonization due to recent use of antibiotics, not a urinary infection