Treatment Options

Drugs used to treat uncomplicated UTI 11,12,13,14,15,16,17,18

Drug

Dosing Regimen

Contraindications/Cautions

Common adverse effects

Patient education

Nitrofurantoin

100mg twice daily for five days

 

●      Creatinine Clearance </= 60

●      Previous allergy or adverse reaction

●      Use with caution in patient >/= 65 years secondary to an increased risk for side effects.

●      Pregnancy at 38-42 weeks due to hemolytic anemia risk

 

●      Nausea 8%

●      Headache 6%

●      Hepatotoxicity

●      Pulmonary toxicity

●      Neuropathy with long term use

 

●      May cause urine discoloration

●      Take with food

●      Safe for use in breastfeeding, monitor infant for jaundice and evidence of hemolysis

TMP-SMX 160/800

One tablet twice daily for three days

●      Allergy to Sulfa,

●      Local resistance rates >/= 20%

●      Megaloblastic anemia

●      GDPD deficiency

●      Severe liver disease

●      Reduce dose by 50% if CrCl is 15-30 ml/min.

●      Contraindicated if CrCl less than 15 ml/min.

●      Avoid breastfeeding in mothers whose infants have G6PD deficiency, also infants who are jaundiced, preterm, or have hyperbilirubinemia.

●      Nausea/vomiting

●      Crystalluria

●      AKI

●      Skin rash

●      Stevens-Johnson Syndrome (SJS)

●      Erythema multiforme

●      Hyperkalemia

●      Bone marrow suppression

●      Hypoglycemia

 

●      Administer without regard to food, take with a full 8 ounces of water.

●      Provide information on SJS

●      Educate on signs of hyperkalemia (heart palpitations, lethargy, confusion, lightheadedness, numbness, shortness of breath)

●      Educate about hypoglycemia warning signs; syncope, weakness, fatigue, dizziness, confusion, and hunger.

Fosfomycin

3g single dose

 

Mix with 8 ounces of cool water

●      Hypersensitivity to Fosfomycin or its components

●      Diarrhea (10.4%)

●      Headache (10.3%)

●      Vaginitis (7.6%)

●      Nausea (5.2%)

●      Take with food to increase absorption

●      Discuss breastfeeding with prescriber as Fosfomycin does distribute into the breastmilk

 

Pharmacists should discuss the signs and symptoms of Clostridium difficile infection with any patient taking antibiotics.  These symptoms can present as worsening fever, severe watery diarrhea, or abdominal cramping.   Patients should seek immediate medical attention if they develop C. difficile infection.

Close Bitnami banner
Bitnami