Acute Cystitis
E. coli
Cephalexin:
Children <12 years of age: 50mg/kg/day PO div q8h (max 500 mg/dose)
Children >12 years of age:
50mg/kg/day PO div q12h (max 500mg/dose)
OR, if IV administration is desired:
Cefazolin: 100mg/kg/day IV div q8h (max 1000mg/dose)
OR
Children >12 years of age:
Nitrofurantoin: 100 mg PO BID¹³
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(NOTE: Nitrofurantoin can ONLY be used for cystitis, it CANNOT be used for treatment of pyelonephritis)
Empiric Therapy & Alternative Regimens
Duration of Therapy & Clinical Pearls
If patient has history of prior urinary tract infections, target empiric therapy based on past susceptibilities.
NOTE: TMP/SMX is another common empiric treatment option for acute cystitis but given decreasing E. coli susceptibility to this agent, other empiric choices are more likely to be effective. Can consider transitioning to Bactrim pending urine culture results.
Length of Therapy:
3 days