Treatment Strategies for Acute Uncomplicated Cystitis | |||
| DRUG AND DOSE | ESTIMATED CLINICAL EFFICACY, % | ESTIMATED BACTERIAL EFFICACY,a % | COMMON SIDE EFFECTS |
|---|---|---|---|
| Nitrofurantoin, 100 mg bid × 5-7 d | 87-95 | 82-92 | Nausea, headache |
| TMP-SMX, 1 DS tablet bid × 3 d | 86-100 | 85-100 | Rash, urticaria, nausea, vomiting, hematologic abnormalities |
| Fosfomycin, 3-g single-dose sachet | 83-95 | 78-98 | Diarrhea, nausea, headache |
| Pivmecillinam, 400 mg bid × 3-7 d | 55-82 | 74-84 | Nausea, vomiting, diarrhea |
| Fluoroquinolones, dose varies by agent; 3-d regimen | 81-98 | 78-96 | Nausea, vomiting, diarrhea, headache, drowsiness, insomnia |
| β-Lactams, dose varies by agent; 5- to 7-d regimen | 79-98 | 74-98 | Diarrhea, nausea, vomiting, rash, urticaria |
aMicrobial response as measured by reduction of bacterial counts in the urine.
Note: Efficacy rates are averages or ranges calculated from the data and studies included in the 2010 Infectious Diseases Society of America/European Society of Clinical Microbiology and Infectious Diseases guideline for treatment of uncomplicated UTI and the 2014 JAMA systematic review on UTI in the outpatient setting. Ranges are estimates from published studies and may vary by specific agent and by rate of resistance.
Abbreviations: DS, double-strength; TMP-SMX, trimethoprim-sulfamethoxazole.