CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Urinary tract infection (lower) - women - Management
Which antibiotic should I prescribe empirically for UTI in a woman with an indwelling urinary catheter?
- Follow local guidelines when available. Otherwise:
- For empirical treatment, prescribe either:
- Trimethoprim 200 mg twice daily, for 7 days, or
- Nitrofurantoin 50 mg four times daily, or 100 mg (modified-release) twice daily, for 7 days.
- If the woman has a history of recurrent infections, or has recently (within the past year) taken trimethoprim, do not use trimethoprim for empirical treatment.
Basis for recommendation
Choosing an antibiotic
- As there is no direct evidence from clinical trials of different antibiotics in women with an indwelling urinary catheter, the recommendation to prescribe trimethoprim or nitrofurantoin for empirical treatment of cystitis is based on the recommendations in Managing suspected cystitis.
Treating for 7 days
- Antibiotic treatment for 7 days is recommended because there is only weak evidence from one small trial that shorter courses are equally effective for urinary tract infection in people with an indwelling urinary catheter.
© NHS Institute for Innovation and Improvement