National Academies Press: OpenBook

Clinical Practice Guidelines: Directions for a New Program (1990)

Chapter: Acute Dysuria in the Adult Female

« Previous: Dysuria Algorithm
Suggested Citation:"Acute Dysuria in the Adult Female." Institute of Medicine. 1990. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press. doi: 10.17226/1626.
Page 148

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

APPENDIX B 148 Acute Dysuria in the Adult Female A. A primary goal of this algorithm is to separate women with acute uncomplicated UTI that can be treated with single dose antibiotic therapy from women with complicated UTI that will require further evaluation or longer duration of therapy. Therefore, women who have symptoms longer than 2 or 3 days, women who have fever or flank pain, pregnant women and women with frequent recurrences or other underlying medical problems need to be eliminated from this algorithm. Initial steps in their management are suggested at branch points of this algorithm, but other algorithms will be necessary to more fully address the management of these groups of patients. Stamm, W., Causes of the Acute Urethral Syndrome in Women, NEJM 1980; 303; 409-415. B. Choices for multiple dose Rx include 7-10 day course of: 1. Trimethoprim sulfa DS BID (contraindicated in pregnancy, known G6PD deficiency or allergic Hx). 2. Amoxicillin 250 mg po tid (1st choice in pregnancy). 3. Nitrofurantoin 50 mg QID (alternative for patient with multiple allergies or pregnant patient with Hx Pen allergy). C. Prophylaxis is usually continued for 6 months. Options for prophylaxis include: 1. Trimethoprim sulfa 1/2 regular strength tab, QHS. 2. Nitrofurantoin 50 mg QHS (in pregnant patient or patient with Hx T/X allergy or known G6PD deficiency). Ronald, A. and Harding, G., Urinary Infection Prophylaxis in Women, Annals Int. Med.1981; 94(2) 268-269. D. Options for single dose Rx include: 1. Trimethoprim sulfa DS 2 tabs x 1. 2. Amoxicillin 3 gm po x 1. Kamaroff, A., Acute Dysuria in Women, NEJM 1984; 310; 368-375. E. Patients who have failed single dose Rx should be considered to have upper tract infection and treated per pyelo protocol.

Next: Appendix C Next Steps for the Institute of Medicine »
Clinical Practice Guidelines: Directions for a New Program Get This Book
Buy Paperback | $50.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF
  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook,'s online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!