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Urinary tract infection (lower) - women - Management
How should I manage a pregnant woman whose cystitis has failed to respond to antibiotics?
- Check compliance with antibiotic treatment.
- Continue symptomatic treatment with paracetamol or, in the first or second trimesters, ibuprofen.
- Send a urine sample for culture.
- If symptoms are troublesome, offer a different antibiotic (nitrofurantoin or trimethoprim) while waiting for the culture results — see Managing suspected acute cystitis during pregnancy.
- If infection is confirmed on culture, treat with an antibiotic to which the organism is sensitive.
- If infection is not confirmed on culture, consider other possible causes for the symptoms — see Differential diagnosis.
- If cystitis symptoms fail to respond to a second antibiotic shown by urine culture results to be appropriate treatment, seek specialist advice.
In depth
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