Cystitis

A. CHILDREN AGE 10 AND UNDER

1. TMP/SMX (Bactrim, Septra) 6-12 mg/kg/day TMP and 30-60 mg/kg/day SMX PO divided bid [C; D in 3rd trimester] Easy dose: 1 mL/kg/day PO divided bid = 8 mg/kg/day TMP and 40 mg/kg/day SMX

Maximum: 20 mL/dose

Suspension of TMP 40 mg and SMX 200 mg/5 mL

2. Amoxicillin (Amoxil) 20-40 mg/kg/day PO divided t.i.d. [B] Easy dose: 30 mg/kg/day = 10 mg/kg/dose PO tid

Maximum: 250 mg/dose

Available in suspensions of 125 mg and 250 mg/5 mL

3. Amoxicillin/clavulanate (Augmentin) 20-40 mg/kg/day (as amoxicillin) PO divided tid [B] Easy dose: 30 mg/kg/day = 10 mg/kg/dose PO tid

Maximum: 500 mg/dose

Available in suspensions of 125 mg and 250 mg amoxicillin/5 mL

4. Cefuroxime axetil (Ceftin) 20-30 mg/kg/day PO divided bid [B] Easy dose: 20 mg/kg/day = 10 mg/kg/dose PO bid

Maximum: 250 mg/dose

Available in suspension of 125 mg/5 mL

5. Cefixime (Suprax) 8 mg/kg/day PO in 1 dose [B] Maximum: 400 mg/day

Suspension 100 mg/5 mL

B. ADULTS AND CHILDREN OLDER THAN 10 Notes:

1. If patient has significant bladder pain, add phenazopyridine (Pyridium) 200 mg PO tid after meals for 2 days [B] (will turn the urine red/orange color)

2. For uncomplicated cystitis in adult females (non-pregnant, non-diabetic) with symptoms of short duration, consider short course therapy:

a. TMP/SMX DS (Bactrim DS, Septra DS) 1 tablet PO bid for 3 days [C; D in 3rd trimester]

b. Ciprofloxacin (Cipro) 500 mg PO bid for 3 days [C]

c. Ofloxacin (Floxin) 200 mg PO bid for 3 days [C]

d. Norfloxacin (Noroxin) 400 mg PO bid for 3 days [C]

e. Fosfomycin (Monurol) 3 g PO single dose [B]

1. TMP/SMX DS (Bactrim DS, Septra DS) 1 tablet PO bid [C; D in 3rd trimester]

2. Ciprofloxacin (Cipro) 500 mg PO bid [C]

4. Norfloxacin (Noroxin) 400 mg PO bid [C]

5. Levofloxacin (Levaquin) 500 mg PO qd [C]

6. Amoxicillin/clavulanic acid (Augmentin) 250 mg PO tid [B]

7. Cefuroxime axetil (Ceftin) 250 mg PO bid [B]

Course: 7 to 10 days (See Notes below) Organisms: E. coli, enterococci, Staph sp.

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