Getting with UTI Treatment Guidelines

An educational intervention in an emergency department led to improvements in guideline-concordant antibiotic selection for urinary tract infections.

The Infectious Diseases Society of America guidelines for treating uncomplicated urinary tract infections (UTIs) recommend that nitrofurantoin be used as first-line therapy for cystitis, except when renal insufficiency is present, and that cephalexin be considered as an acceptable alternative. Trimethoprim-sulfamethoxazole and ciprofloxacin are recommended as second- and third-line options, respectively. For pyelonephritis, intravenous ceftriaxone (1g) is recommended when fluoroquinolone resistance exceeds 10%, and outpatient therapy should be with ciprofloxacin; trimethoprim-sulfamethoxazole and cephalexin are second-line options. Customizing treatment choices based on local antibiograms is emphasized.

Now, investigators at a single academi…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Getting with UTI Treatment Guidelines

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Reviewing Author