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Urinary tract infection (lower) - women - Management
What dose of trimethoprim should I prescribe?
- For treatment of urinary tract infection (UTI), prescribe trimethoprim 200 mg twice daily.
- For long-term prophylaxis, prescribe 100 mg at night.
- Reduce the dose if the woman has severe renal impairment — particularly if treatment is prescribed for more than 3 days (for example, people with complicated urinary tract infection or for long-term prophylaxis).
- For a glomerular filtration rate (GFR) of 15–25 mL per minute, prescribe the normal dose for 3 days, then reduce the dose by half.
- For a GFR less than 15 mL per minute, prescribe half the normal dose.
Basis for recommendation
Standard dose
- These doses are based on those recommended by the manufacturer of trimethoprim and the British National Formulary [Actavis, 2007; BNF 57, 2009].
Dose in renal failure
- Dose adjustment is recommended for people with severe renal impairment because of the risk of drug accumulation in these people — 40–60% of the trimethoprim dose (along with its metabolites) is excreted unchanged in the urine within 24 hours [Actavis, 2007].
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