Acute uncomplicated cystitis is often readily recognized by patients as a routine bladder infection. Uncomplicated cystitis rarely progresses to pylonephritis and urosepsis even if untreated. The primary goal of treatment is to relieve symptoms. If a patient presents with pain, urgency and frequent urination
Note: ACOG has replaced Committee opinion 294 (2011) with Committee Opinion 717 (2017) that recommends the cautious use of sulfonamides and nitrofurantoin in the first trimester of pregnancy due to possible risk of birth defects, if no other alternatives are available (see ‘Related ObG Topics’ below)
Note: FDA (endorsed in ACOG Practice Advisory) recommends the following
FDA has approved label changes that reserve the use of fluoroquinolone antibacterial medicines when treating acute bacterial sinusitis (ABS), acute bacterial exacerbation of chronic bronchitis (ABECB), and uncomplicated urinary tract infections (UTI) for patients who do not have alternative treatment options.
UTI is the most common infection encountered in the outpatient setting. By age 32, half of all women will have had at least one UTI. Recurrence rates are over 25%. Fluoroquinolones are effective, but the recommendation is to avoid as a first-line medication to prevent future resistance and maintain these medications as a second-line treatment when needed.
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