Male Cystitis/Pyelo - Uncomp

There is a high prevalence of asymptomatic bacteriuria and pyuria in nursing home patients, which does NOT require treatment (leads to resistance).

UTI should only be diagnosed and treated in patients with genitourinary symptoms.

Avoid catheterization

For patients with nonspecific symptoms (falls, change in mental status), improving hydration often resolves symptoms - withhold ABx 24hrs and reassess

Fluoroquinolones and TMP-SMX are preferred due to prostatic penetration, but >20% resistance to TMP-SMX for E. coli in Eastern Health.

Beta-lactam can be used if susceptible for 14d therapy

Nitrofurantoin is not recommended in men

Shorter duration antimicrobial therapy may be appropriate in some cases