Page 269 - Learnwell EVS
P. 269
9. Genito-urinary diseases
Treatment
Cystitis in girls ≥ 2 years
cefixime P O : 8 m g /kg once d aily for 3 d ays
or amoxicillin/clavulanic acid P O (d ose expressed in am oxicillin) 25 m g /kg /d ay in
2 d iv id ed d oses (w ith form ulation 8:1 or 7:1 or 4:1)
N ote: th e d ose of clav ulanic acid sh ould not exceed 12.5 m g /kg /d ay (or 375 m g /d ay).
Cystitis in non pregnant women
– If d ipstick analysis is positiv e for both nitrites and leukocytes:
fosfomycin-trometamine P O : 3 g as a sing le d ose
or ciprofloxacin P O : 500 m g /d ay in 2 d iv id ed d oses for 3 d ays
or nitrofurantoin P O (except in patients w ith G6P D d eficiency): 300 m g /d ay in
3 d iv id ed d oses for 5 d ays
– If d ipstick analysis is neg ativ e for nitrites but positiv e for leukocytes, th e infection
m ay be d ue to S. saprophyticus. Fosfom ycin is not activ e ag ainst th is path og en. U se
ciprofloxacin or nitrofurantoin, as abov e.
– W h atev er th e antibiotic used , sym ptom s m ay persist for 2 to 3 d ays d espite ad equate
treatm ent.
– In th e ev ent of treatm ent failure (or recurrent cystitis i.e. > 3-4 episod es/year),
ciprofloxacin P O : 1 g /d ay in 2 d iv id ed d oses for 5 d ays
– For patients with recurrent cystitis, consid er blad d er stones, urinary sch istosom iasis,
urinary tuberculosis or g onorrh oea (exam ine th e partner).
Cystitis in pregnant or lactating women
fosfomycine-tromethamine P O as abov e 9
or cefixime P O : 400 m g /d ay in 2 d iv id ed d oses for 5 d ays
or nitrofurantoin P O (except in th e last m onth of preg nancy, th e first m onth of breast-
feed ing and in patients with G6P D d eficiency): 300 m g /d ay in 3 d iv id ed d oses for 5 to
7 d ays
225
Treatment
Cystitis in girls ≥ 2 years
cefixime P O : 8 m g /kg once d aily for 3 d ays
or amoxicillin/clavulanic acid P O (d ose expressed in am oxicillin) 25 m g /kg /d ay in
2 d iv id ed d oses (w ith form ulation 8:1 or 7:1 or 4:1)
N ote: th e d ose of clav ulanic acid sh ould not exceed 12.5 m g /kg /d ay (or 375 m g /d ay).
Cystitis in non pregnant women
– If d ipstick analysis is positiv e for both nitrites and leukocytes:
fosfomycin-trometamine P O : 3 g as a sing le d ose
or ciprofloxacin P O : 500 m g /d ay in 2 d iv id ed d oses for 3 d ays
or nitrofurantoin P O (except in patients w ith G6P D d eficiency): 300 m g /d ay in
3 d iv id ed d oses for 5 d ays
– If d ipstick analysis is neg ativ e for nitrites but positiv e for leukocytes, th e infection
m ay be d ue to S. saprophyticus. Fosfom ycin is not activ e ag ainst th is path og en. U se
ciprofloxacin or nitrofurantoin, as abov e.
– W h atev er th e antibiotic used , sym ptom s m ay persist for 2 to 3 d ays d espite ad equate
treatm ent.
– In th e ev ent of treatm ent failure (or recurrent cystitis i.e. > 3-4 episod es/year),
ciprofloxacin P O : 1 g /d ay in 2 d iv id ed d oses for 5 d ays
– For patients with recurrent cystitis, consid er blad d er stones, urinary sch istosom iasis,
urinary tuberculosis or g onorrh oea (exam ine th e partner).
Cystitis in pregnant or lactating women
fosfomycine-tromethamine P O as abov e 9
or cefixime P O : 400 m g /d ay in 2 d iv id ed d oses for 5 d ays
or nitrofurantoin P O (except in th e last m onth of preg nancy, th e first m onth of breast-
feed ing and in patients with G6P D d eficiency): 300 m g /d ay in 3 d iv id ed d oses for 5 to
7 d ays
225
