Treatment
- Oral or intravenous antibiotics
- oral antibiotics should be given first line if the person can take oral medicines, and the severity of their condition does not require intravenous antibiotics
- if intravenous antibiotics then review intravenous antibiotics by 48 hours and consider stepping down to oral antibiotics where possible
Reassessment
- reassess if symptoms worsen at any time, or do not start to improve within 48 hours of taking the antibiotic, taking account of:
- other possible diagnoses
- any symptoms or signs suggesting a more serious illness or condition, such as sepsis
- previous antibiotic use, which may have led to resistant bacteria.
Antibiotics for pregnant women aged 12 years and over
First-choice oral antibiotic2
- Cefalexin - 500 mg twice or three times a day (up to 1 to 1.5 g three or four times a day for severe infections) for 7 to 10 days
First-choice intravenous antibiotic (if vomiting, unable to take oral antibiotics, or severely unwell)2,3
- cefuroxime 750 mg to 1.5 g three or four times a day
- Second-choice antibiotics or combining antibiotics if susceptibility or sepsis a concern > consult local microbiologist
- 1 check British national formulary (BNF) for appropriate use and dosing in specific populations, for example, hepatic impairment and renal impairment, and administering intravenous antibiotics.
- 2 check any previous urine culture and susceptibility results and antibiotic prescribing and choose antibiotics accordingly.
- 3 review intravenous antibiotics by 48 hours and consider stepping down to oral antibiotics where possible.
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