This handout is for uncomplicated uti (acute cystitis, non-pregnant adult). Your care team identified this based on: dysuria + frequency + urgency in adult woman (idsa 2010 pmid 21292654 — high ppv alone for cystitis).
Other reasons your team may use this plan: suprapubic discomfort + cystitis symptoms (idsa 2010); gross hematuria + cystitis symptoms (still uncomplicated if no fever/flank pain) (idsa 2010); recurrent uti (≥2/6mo or ≥3/12mo) → prophylaxis discussion (aua 2022).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| nitrofurantoin | 100 mg PO BID | PO | BID × 5 days | IDSA 2010 first-line — bactericidal in urine; minimal collateral damage; AVOID if CrCl <30 (insufficient urinary concentration) and AVOID in pyelonephritis (does not concentrate in renal tissue) (Gupta PMID 21292654) |
| fosfomycin | 3 g PO × 1 dose | PO | single dose | IDSA 2010 first-line single-dose convenience; lower 5-d cure rate than nitrofurantoin per Cochrane (Gupta PMID 21292654) |
| trimethoprim-sulfamethoxazole | 160/800 mg (DS) PO BID | PO | BID × 3 days | IDSA 2010 first-line ONLY if local E. coli resistance <20% AND no recent (≤3 mo) TMP-SMX exposure (Gupta PMID 21292654) |
Plan: Uncomplicated UTI — IDSA 2010 first-line empirics + pregnancy regimen + recurrent UTI prophylaxis (AUA 2022)
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Recurrent UTI → prophylaxis options (continuous low-dose, post-coital, topical vaginal estrogen postmenopausal, methenamine, cranberry weak per AUA 2022); urology referral if breakthrough on prophylaxis (AUA 2022)
Guideline: IDSA 2011 Acute Uncomplicated Cystitis/Pyelonephritis (Gupta) + Hooton NEJM 2012 uncomplicated-UTI review + IDSA Asymptomatic Bacteriuria 2019 (Nicolle) + AUA/CUA/SUFU Recurrent UTI 2019 (Anger) + fluoroquinolone disabling-ADR / FDA safety evidence