Common organisms
- • E. coli (~80%)
- • Klebsiella
- • Proteus
- • Enterococcus
Empirical therapy
- • Uncomplicated cystitis: Nitrofurantoin 100 mg BD x 5d OR Fosfomycin 3 g single dose
- • Pyelonephritis: Ceftriaxone 1-2 g IV OD
- • Sepsis: Piptaz + consider aminoglycoside
Culture-directed
- • ESBL: Carbapenem (Ertapenem / Meropenem)
- • Enterococcus: Amoxicillin
Adverse effects
- • Nitrofurantoin: pulmonary fibrosis (long-term)
- • Aminoglycoside: nephro/ototoxic
Monitoring
- • Defervescence by 48-72h
- • Repeat urine culture if symptoms persist
Clinical pearls
- • Always exclude obstruction in non-responders
- • Treat 7-14d for pyelo, 14d if male
Educational support only — follow local antibiogram and institutional protocols.
