Spectrum: Local Antimicrobial Stewardship, for Eastern Health

Male Cystitis/Pyelo - Uncomp

Note

Avoid catheterization

Suggested Empiric Rx

The choice between the following agents should be made based on the acuity of illness, previous culture data from the same patient, risk factors for drug resistant organisms, and appropriate antibiogram data (i.e. community vs hospital)

PO: TMP-SMX DS 1 tab po BID x 7-14d

OR

PO: Ciprofloxacin 500mg po BID x 7-14d

OR

Cystitis only: Fosfomycin 3g po q3days x 3 doses (not recommended for pyelonephritis and prostatitis)

OR

IV: Ceftriaxone 1g IV daily

OR

IV: Gentamicin 5 to 7 mg/kg IV daily

may need to calculate adjusted body weight if patient obese, see drug monograph

OR

IV: Ertapenem 1g IV daily - If known to be colonized ESBL, consider if multiple risk factors

ESBL RFs

Healthcare: prolonged hospitalization, ICU stay, percutaneous feeding tubes, nursing home residence, urinary catheterization

Travel within 6-12 months to area of high prevalence (i.e. South Asia), especially when received medical care while abroad Antimicrobial exposure