Title UTI in non pregnancy.pdf ✅

Version: 11 June 2024 National Antimicrobial Guideline, 4th Edition (2024) Clinical Pathways for Primary Care: Urinary Tract Infection in Non-Pregnancy Assess for presence of pyelonephritis: High grade fever, nausea / vomiting, flank pain, leukocytosis, costovertebrae tenderness Risk factors for complicated UTI: Immunosuppressed Poorly controlled diabetes mellitus Post-menopausal Urinary tract obstruction Urolithiasis UTI in men CKD Urinary catheter in situ Neurogenic bladder Recurrent UTI Perform urinalysis and urine culture Severe symptoms (patient has ≥3 symptoms suggestive of UTI) Non-severe sx (patient has <3 symptoms suggestive of UTI) Treat with antibiotics UTI or other dx equally likely Review technique and time of specimen (morning most reliable) Refer hospital Perform urinalysis Uncomplicated UTI Nit +ve Unlikely UTI Consider other dx e.g. vaginitis Nit –ve Leu +ve Treat with antibiotics if urinalysis indicates probable UTI Nit –ve Leu –ve Probable UTI Treat with antibiotics TCA to review symptoms and culture Send urine culture and consider delayed antibiotic prescription Antibiotics Dosing Duration** Remarks Nitrofurantoin* 50-100mg PO q6h (immediate release) OR 100mg PO q12h (modified release) 5 days Preferred Cephalexin 500mg PO q6-12h** 5 days Preferred Amoxycillin/ Clavulanate 625mg PO q8h 3-5 days Alternative Ampicillin / Sulbactam 375-750mg PO q12h 3-5 days Alternative Cefuroxime 500mg PO q12h 3-5 days Alternative * Nitrofurantion is contraindicated when eGFR is <30 ml/min. ** Consider q6h frequency in patients at risk of complicated UTI 1. UTI (lower): Antimicrobial Prescribing. NICE Guideline May 2022. 2. The WHO AWaRe (Access, Watch, Reserve) antibiotic book 2022. Yes No Suspected of urinary tract infection (ADULTS, NON-PREGNANT) Frequency, dysuria, hematuria, suprapubic pain, urgency, polyuria