This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Antibiotics for non-pregnant women and men aged 16 years and over

Authoring team

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.

Antibiotics1 for non-pregnant women and men aged 16 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
    • OR
  • co-amoxiclav (only if culture results available and susceptible) - 500/125 mg three times a day for 7 to 10 days
    • OR
  • trimethoprim (only if culture results available and susceptible) - 200 mg twice a day for 14 days
    • OR
  • ciprofloxacin (consider safety issues3) - 500mg twice a day for 7 days

First choice intravenous antibiotics (if vomiting, unable to take oral antibiotics, or severely unwell). Antibiotics may be combined if susceptibilty or sepsis a concern 2, 4

  • co-amoxiclav (only in combination or if culture results available and susceptible)
    • 1.2 g three times a day Cefuroxime 750 mg to 1.5 g three or four times a day

    • OR
  • ceftriaxone
    • 1 to 2 g once a day

    • OR
  • ciprofloxacin (consider safety issues3)
    • 400 mg twice or three times a day

    • OR
  • gentamicin
    • Initially 5 mg/kg to 7 mg/kg once a day, subsequent doses adjusted according to serum gentamicin concentration5

    • OR
  • amikacin Initially
    • 15 mg/kg once a day (maximum per dose 1.5 g once a day), subsequent doses adjusted according to serum amikacin concentration (maximum 15 g per course)

  • 1 check British national formulary (BNF) for appropriate use and dosing in specific populations, for example, hepatic impairment, renal impairment and breastfeeding, and administering intravenous antibiotics.
  • 2 check any previous urine culture and susceptibility results and antibiotic prescribing and choose antibiotics accordingly.
  • 3 the European Medicines Agency's Pharmacovigilance Risk Assessment Committee has recommended restricting the use of fluoroquinolone antibiotics following a review of disabling and potentially long-lasting side effects mainly involving muscles, tendons, bones and the nervous system (press release October 2018), but they are an option in acute pyelonephritis, which is a severe infection.
  • 4 review intravenous antibiotics by 48 hours and consider stepping down to oral antibiotics where possible.
  • 5 Therapeutic drug monitoring and assessment of renal function is required (BNF, August 2018)

Reference:


Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.