Continuous antibiotic prophylaxis for recurrent UTI in nonpregnant females
Do not give antibiotic prophylaxis to patients with asymptomatic bacteriuria.
For continuous prophylaxis of recurrent urinary tract infection (UTI) in nonpregnant females1, useAhmed, 2017Bonkat, 2024Dason, 2011Gupta, 2013Zare, 2022:
1trimethoprim 150 mg orally, at night. For dosage adjustment in adults with kidney impairment, see trimethoprim dosage adjustment trimethoprim trimethoprim trimethoprim
OR
2cefalexin 250 mg orally, at night. For dosage adjustment in adults with kidney impairment, see cefalexin dosage adjustment cefalexin cefalexin cefalexin
OR
3nitrofurantoin 50 mg orally, at night. For dosage adjustment in adults with kidney impairment, see nitrofurantoin dosage adjustment. nitrofurantoin nitrofurantoin nitrofurantoin
Typically, continuous prophylaxis is used for 6 months and then stoppedZare, 2022. If UTI recurs once continuous prophylaxis is stopped, reassess the patient to determine the best approach for continued prevention of recurrent UTIZare, 2022.
Long-term use of nitrofurantoin has been associated with an increased risk of rare adverse effects, including pulmonary toxicity, hepatotoxicity and peripheral polyneuropathy. Monitor for these adverse effects with regular spirometry, liver function and kidney function tests. Polyneuropathy is more likely to occur in patients with impaired kidney function.
If UTI recurs despite continuous antibiotic prophylaxis, seek expert advice.