Lower urinary tract infection/cystitis in pregnancy

Antimicrobial prescribing: NHS Lothian
NHS Lothian

If evidence of systemic infection or pyelonephritis including rigours, or back pain follow guidance here.

Send a urine culture in all women prior to starting antibiotics and review the results and tailor antibiotic prescribing accordingly.

Antibiotic recommendation

Recommended total duration: 7 days

Nitrofurantoin 50 mg every 6 hours or 100mg MR every 12 hours orally. 

Do not use nitrofurantoin if eGFR ≤45ml/min/1.73m2 or at term in pregnancy because it may produce neonatal haemolysis.

Alternative: Cefalexin 500mg every 12 hours orally.
Alternative if susceptible: Amoxicillin  500mg every 8 hours