Spectrum: Local Antimicrobial Stewardship, for Fraser Health

Pregnancy (Acute cystitis)

Duration of Therapy

7 days

First Line

Nitrofurantoin (MacroBID) 100 mg PO BID (CrCl>30 only)

Should be avoided after 38 weeks gestation

Second Line

TMP/SMX 1 DS tab PO BID

Should be avoided in 1st trimester and after 32 weeks gestation

OR

Amoxicillin-clavulanate 875-125 mg one tab PO BID

Third Line

Cefixime 400 mg PO daily

OR

Fosfomycin 3 g PO once

Note

Oral regimen preferred from outset in most patients. If started on parenteral agent, switch to oral agent as soon as feasible