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GENITOURINARY - UTI - Adult - Acute Uncomplicated Cystitis (E. coli, S. saprophyticus, other enterobacteria, Proteus, Enterococci)
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Cephalexin (Kelfex®) Generics available Pregnancy: B; Lactation: Unk
Caps: 250, 500 & 750 mg Tabs: 250 mg, 500 mg Powder for Oral Suspension: 125 mg/5 mL 250 mg/5 mL
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Children <15 y.o.: Usual dose 25-50 mg/kg/day in divided doses 2 to 4 times daily (max 4 g/day).
125 mg/5 mL @ 25 mg/kg/day (double for 50 mg/kg/day) 10 kg (22 lb) = 1 tsp (5 mL) Q12H 15 kg (33 lb) = 1 tsp (5 mL) Q8H
250 mg/5 mL @ 25 mg/kg/day (double for 50 mg/kg/day) 20 kg (44 lb) = 1 tsp (5 mL) Q12H or 1/2 tsp (2.5 mL) Q6H 40 kg (88 lb) = 1 tsp (5 mL) Q6H >40 kg = Use adult dose.
Adult: 250mg Q6h or 500mg Q12 h (Dosing range 1-4 g daily in 2 to 4 divided doses.) |
Food: May take with food if GI upset occurs.
Important side effects: Nausea, vomiting, rash, diarrhea, elevated LFTs.
Caution: Avoid use in patients with history of severe penicillin allergy. Use with caution in patients with history of seizures.
Reduce dose in renal disease: CrCl 10-40 mL/min give standard dose every 8-12 hours CrCl <10 mL/min give standard dose every 12-24 hours |
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Ciprofloxacin (Cipro®) Pregnancy: C; Lactation: Unsafe
Tabs: 100 mg, 250 mg, 500 mg |
≥18 and Adult: Young women: 100-250 mg twice daily for 3 days.
Young men and older men without evidence of prostatitis: 250-500 mg twice daily for 7-14 days. |
Food: Take on empty stomach 1 hour before or 2 hours after a meal. May take with food if it causes GI upset, but avoid large amounts of dairy products. May take 2 hours before or 6 hours after sucralfate, antacids, aluminum, magnesium, calcium, zinc, iron, sucralfate, vitamins, or mineral supplements.
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Important side effects: Photosensitivity, dizziness.
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Reduce dose in renal disease (CrCl <50 mL/min).
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Levofloxacin (Levaquin®) Pregnancy: C; Lactation: Unsafe
Tabs: 250 mg, 500 mg |
≥18 and Adult: Young women: 250 mg daily for 3 days.
Young men and older men without evidence of prostatitis: 250 mg daily for 7-14 days. |
Food: May take with or without meals. Do not take within 2 hours of antacids, magnesium, calcium supplements, zinc, aluminum, sucralfate, vitamins, or minerals (iron or zinc).
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Important side effects: Photosensitivity, dizziness.
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Reduce dose in renal disease (CrCl <50 mL/min).
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Nitrofurantoin (Macrodantin®, Macrobid®) Generics available Pregnancy: B; (Do not use at term or in labor) Lactation: Unsafe
Caps: 25 mg, 50 mg, 100 mg Oral Susp: 25 mg/5 mL
Macrobid (extended release): 100 mg Q12H
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Young women: 50-100 mg PO every 6 hours for 3 days or Macrobid 100 mg PO every 12 hours for 3 days.
Young men and older men without evidence of prostatitis: Not recommended for use in men due to poor tissue penetration. |
Food: Take with food or milk.
Important side effects: Nausea, vomiting, darkening of the urine, headache, hepatitis, peripheral neuropathy.
Ineffective if CrCl ≤40 mL/min |
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*E. coli resistance increasing and may be significant. Not advocated as first-line therapy.
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Trimethoprim/Sulfamethoxazole (Bactrim®, Septra®) Generics available Pregnancy: C; Lactation: Unsafe
Single strength (SS) Tabs: 80 mg/400 mg
Double Strength (DS) Tabs: 160 mg/800 mg Oral Susp: 40 mg/200 mg/5 mL
*E. coli resistance may be 15-20% and may require alternative therapy in many locales.
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Young women: 1 DS tablet twice daily for 3 days.
Young men and older men without evidence of prostatitis: 1 DS tablet twice daily for 7-14 days. |
Food: May take without regard to food. Encourage fluids.
Important side effects: Photosensitivity, rash.
Reduce dose in renal disease (CrCl <30 mL/min). |
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GENITOURINARY - UTI - Child - Acute Uncomplicated Cystitis (E. coli, Enterobacter, Klebsiella)
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Amoxicillin/clavulanate (Augmentin®)
Q12H Formulations: Tabs: 500 mg/125 mg, 875 mg/125 mg
Chewable Tabs: 200 mg/28.5 mg, 400 mg/57 mg
Oral Susp: 200 mg/28.5 mg/5 mL, 400 mg/57 mg/5 mL Child - |
Children: 40-50 mg amoxicillin component/kg/day (max 1600 mg/day) in divided doses two or three times daily for 7 days.
Q12H using 200 mg/5 mL susp @ 45 mg/kg/day 9 kg (20 lb) = 1 tsp (5 mL) Q12H 13 kg (29 lb) = 1½ tsp (7.5 mL) Q12H 18 kg (40 lb) = 2 tsp (10 mL) Q12H
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Food: Take with food to reduce diarrhea.
Important side effects: Diarrhea (common), nausea, rash.
Use with caution in hepatic disease.
Reduce dose in renal disease (CrCl <30 mL/min). |
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Q12H using 400 mg/5 mL susp |
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@ 45 mg/kg/day |
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18 kg (40 lb) = 1 tsp (5 mL) Q12H |
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27 kg (59 lb) = 1½ tsp (7.5 mL) Q12H |
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35 kg (77 lb) = 2 tsp (10 mL) Q12H |
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>40 kg = Use adult dose (max 875 mg Q12H). |
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Note: Q12H dosing may improve compliance compared to Q8H dosing.
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Cefixime (Suprax®) Tabs: 200 mg, 400 mg |
Children: 8 mg/kg/day (max 400 mg/day) as single dose or divided twice daily for 7 days. |
Food: May administer on empty stomach. May administer with food to reduce GI distress.
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Oral Susp: 100 mg/5 mL |
100 mg/5 mL @ 8 mg/kg/day |
Important side effects: Nausea, diarrhea. |
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12.5 kg (27.5 lb) = ½ tsp (2.5 mL) Q12H |
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19 kg (42 lb) = ¾ tsp Q12H |
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25 kg (55 lb) = 1 tsp (5 mL) Q12H |
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38 kg (77 lb) = 1½ (7.5 mL) Q12H |
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>50 kg (110 lb) = Use adult dose.
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Cefpodoxime (Vantin®) Tabs: 100 mg - 200 mg
Granules for Oral Suspension: 50 mg/5 mL |
Children ≥5 months to 12 years: 10 mg/kg/day (max 400 mg/day) in one or two divided doses for 7 days.
50 mg/5 mL @ 10 mg/kg/day 10 kg (22 lb) = 1 tsp (5 mL) Q12H 15 kg (33 lb) = 1½ tsp (7.5 mL) Q12H
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Food: Take tablet with food. Suspension may be taken without regard to food.
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Important side effects: Nausea, vomiting, rash, diarrhea, elevated LFTs.
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Caution: Use with caution in patients with history of seizures. |
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100 mg/5 mL @10 mg/kg/day 15 kg (33 lb) = ¾ tsp Q12H 20 kg (44 lb) = 1 tsp (5 mL) Q12H 30 kg (66 lb) = 1½ tsp (7.5 mL) Q12H 40 kg (88 lb) = Use adult dose.
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Reduce dose in renal disease. CrCl <30 mL/min increase dosing interval to once daily. |
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Cefprozil (Cefzil®)
Tabs: 250 mg, 500 mg
Powder for Oral Suspension: 125 mg/5 mL 250 mg/5 mL
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Children ≥6 months to 12 years: 7.5-15 mg/kg/day in divided doses 2 times daily (max 1,000 mg/day)
250 mg/5 mL @ 30 mg/kg/day 9.1 kg (20 lb) = ½ tsp (2.5 mL) Q12H 13.6 kg (30 lb) = ¾ tsp Q12H 18.2 kg (40 lb) = 1 tsp (5 mL) Q12H 27 kg (60 lb) = 1½ tsp (7.5 mL) Q12H 31 kg (70 lb) = Use adult dose.
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Food: May be taken without regard to food. May take with food to reduce GI upset.
Important side effects: Nausea, vomiting, rash, diarrhea, elevated LFTs.
Caution: Use with caution in patients with history of seizures.
Reduce dose in renal disease: CrCl <30 mL/min administer 50% of usual dose at standard dosing interval.
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Nitrofurantoin (Macrodantin®, Macrobid®) Generics available
Caps: 25 mg, 50 mg, 100 mg Oral Susp: 25 mg/5 mL
Macrobid (extended release): 100 mg Q12H - *E. coli resistance increasing and may be significant. Not advocated as first-line therapy.
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Children ≥1 month: 5-7 mg/kg/day (max 400 mg/day) in divided doses every 6 hours for 7 days.
25 mg/5 mL @ 5 mg/kg/day 10 kg (22 lb) = ½ tsp (2.5 mL) Q6H 20 kg (44 lb) = 1 tsp (5 mL) Q6H 30 kg (66 lb) = 1½ tsp (7.5 mL) Q6H 40 kg (88 lb) = 2 tsp (10 mL) Q6H
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Food: Take with food or milk.
Important side effects: Nausea, vomiting, darkening of the urine, headache, hepatitis, peripheral neuropathy. Ineffective if CrCl ≤40 mL/min |
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Trimethoprim/ Sulfamethoxazole* (Bactrim®, Septra®) Generics available
Single strength (SS) Tabs: 80 mg/400 mg - < |
Children ≥2 months: 6-12 mg/kg/day TMP component (max 320 mg/day) in divided doses twice daily for 7 days.
40 mg/200 mg/5 mL @ 6-12 mg/kg/day |
Food: May take without regard to food. Encourage fluids.
Important side effects: Photosensitivity, rash.
Reduce dose in renal disease (CrCl <30 mL/min). |
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Double Strength (DS) Tabs: |
10 kg (22 lb) = 1 tsp (5 mL) Q12H |
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160 mg/800 mg
Oral Susp: 40 mg/200 mg/5 mL
*E. coli resistance may be 15-20% and may require alternative therapy in many locales. |
20 kg (44 lb) = 2 tsp (10 mL) or 1 SS tab Q12H 30 kg (66 lb) = 3 tsp (15 mL) or 1½ SS tab Q12H 40 kg (88 lb) = 4 tsp (20 mL) or 2 SS tabs or 1 DS Tab Q12H for 3-5 days
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