| Name | Simple Urinary Tract Infection (UTI) Treatment - Macrobid (Nitrofurantoin), Bactrim (Sulfamethoxazole/Trimethoprim), Keflex (Cephalexin), Augmentin (Amoxicillin/Clavulanate), Fosfomycin, Cipro (Ciprofloxacin) |
| Uses | Treatment of uncomplicated urinary tract infections (acute cystitis) in non-pregnant adults. |
| Route Of Administration | Oral (capsule, tablet, powder for suspension). |
| Frequency Of Use | Once to twice daily depending on antibiotic selection and severity of infection. |
| Concentration(s) | Macrobid: 100 mg; Bactrim: 800 mg/160 mg; Keflex: 250 mg, 500 mg; Augmentin: 500 mg/125 mg; Fosfomycin: 3 g single-dose packet; Cipro: 250 mg, 500 mg. |
| Maximum Dosage (Day, Wk) | Macrobid: 100 mg BID x 5 days; Bactrim: 800 mg/160 mg BID x 3 days; Keflex: 500 mg BID x 5-7 days; Augmentin: 500 mg BID x 5-7 days; Fosfomycin: 3 g single dose; Cipro: 250-500 mg BID x 3 days. |
| Contraindications | Pregnancy (caution with fluoroquinolones and Bactrim), severe renal impairment, sulfa allergy (Bactrim), history of tendon disorders (Cipro). |
| Possible Side Effects | Common: GI upset, diarrhea, headache. Rare: severe allergic reaction, Clostridioides difficile infection, tendon rupture (Cipro). |
| Compatibility With Other Treatments/Drugs | Avoid Cipro with corticosteroids (risk of tendon rupture); avoid Bactrim with warfarin (increased bleeding risk). |
| Allergies | Assess for sulfa allergy (Bactrim), penicillin allergy (Augmentin, Keflex). |
| Administration Time | Macrobid & Bactrim: with food to reduce GI upset; Fosfomycin: mix with water and take on an empty stomach; Cipro: avoid taking with calcium or dairy. |
| Dosing/Settings | Adjust dosing based on renal function. Standard duration 3-7 days depending on antibiotic selection. |
| Test Spot Requirement | Not required for UTI antibiotics. |
| Pre-Treatment Guidelines | Confirm uncomplicated UTI symptoms (dysuria, urgency, frequency, no flank pain/fever). Avoid antibiotics for asymptomatic bacteriuria. |
| Provider Clearance Guidelines | NP, PA, MD, or DO must approve. Assess renal function before prescribing Macrobid or Cipro in older adults. |
| Pre-Treatment Screening Workflow | 1. Confirm typical UTI symptoms. 2. Rule out pyelonephritis or complicated infection. 3. Assess allergies and contraindications. |
| What To Do If Adverse Reaction Occurs | For mild GI symptoms: supportive care. For severe reactions (e.g., anaphylaxis, tendon rupture): discontinue and seek emergency treatment. |
| Clinic Implementation Guidelines | Ensure proper antibiotic stewardship; educate patients on hydration and completing full course of treatment. |
| Photographic Documentation Protocol | Not required for UTI treatment. |
| Post-Treatment Care | Reassess in 3-7 days; if no improvement, obtain urine culture and consider alternative therapy. |
| Additional Documentation Requirements | Signed informed consent, prescription logs, adverse reaction documentation if applicable. |