Urinary tract infection in adults: management

Lower urinary tract infections

Non-pregnant women

local antibiotic guidelines should be followed if available
2012 SIGN guidelines recommend trimethoprim or nitrofurantoin for 3 days

Pregnant women with symptomatic bacteriuria should be treated with an antibiotic for 7 days. A urine culture should be sent. For asymptomatic pregnant women:

a urine culture should be performed routinely at the first antenatal visit
if positive, a second urine culture should be sent to confirm the presence of bacteriuria
SIGN recommend to treat asymptomatic bacteriuria detected during pregnancy with an antibiotic
a 7 day course of antibiotics should be given
a further urine culture should be sent following completion of treatment as a test of cure

Acute pyelonephritis

For patients with sign of acute pyelonephritis hospital admission should be considered

local antibiotic guidelines should be followed if available
the BNF currently recommends a broad-spectrum cephalosporin or a quinolone (for non-pregnant women) for 10-14 days