Urinary Tract Infection - Uncomplicated Drug Summary

Last updated: 27 April 2026
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Aminoglycosides

Drug Dosage Remarks
Amikacin 7.5-15 mg/kg/day IM/IV divided 8-12 hourly or
250 mg IM/IV 12 hourly or
500 mg IM/IV 24 hourly		 Adverse Reactions
  • Ototoxic effects (irreversible hearing loss, dizziness, vertigo); Renal effects (reversible nephrotoxicity, acute renal failure has been reported usually when other nephrotoxic drugs have also been administered); Neuromuscular effects (neuromuscular blockade resulting in resp depression and muscular paralysis)
Special Instructions
  • Use with caution in patients with conditions associated with muscle weakness (eg myasthenia gravis, Parkinson’s disease), patients with pre-existing renal dysfunction, vestibular or cochlear impairment
  • Ototoxicity and nephrotoxicity are most likely in patients who are geriatric, dehydrated, with renal impairment, receiving high doses or for long periods and receiving or have received other ototoxic/nephrotoxic drugs
    • Consider monitoring serum concentrations and/or peak serum concentrations/minimum inhibitory concentration ratio in patients at risk for ototoxicity or nephrotoxicity
Gentamicin 3-5 mg/kg/day IM/IV divided 8 hourly or
160 mg IM/IV 24 hourly
Kanamycin 1-2 g/day IM divided 12-24 hourly
Max dose: 1.5 g/day
Netilmicin 3-4 mg/kg/day IM/IV divided 8-12 hourly or
150 mg IM/IV 12-24 hourly
Streptomycin 1-2 g/day IM divided 6-12 hourly
Max dose: 2 g/day

Antibacterial Combination

Drug Dosage Remarks
Co-trimoxazole
(Sulfamethoxazole [SMZ] and
Trimethoprim [TM])		 800 mg SMZ/160 mg TM PO/IV infusion 12 hourly Adverse Reactions
  • GI effects (nausea/vomiting, anorexia, diarrhea); Dermatologic effect (photosensitivity); Hypersensitivity effects (rash, pruritus, Stevens-Johnson syndrome [SJS]); Urogenital effect (crystallization in the urine)
Special Instruction
  • Maintain adequate fluid intake
  • Contraindicated in patients allergic to sulphonamides
  • Use with extreme caution or not at all in patients with hematological disorders especially megaloblastic anemia due to Folic acid deficiency
  • Use with caution in patients with renal impairment or severe hepatic dysfunction and in patients with folate deficiency (may consider administration of Folinic acid)

Cephalosporins

Drug Dosage Remarks
First Generation Adverse Reactions
  • Hypersensitivity effects (urticaria, pruritus, rash, anaphylaxis); GI effects (diarrhea, nausea/vomiting, increased LFTs); CNS effects (headache, dizziness; high doses associated with encephalopathy and convulsions); Local effects (phlebitis, pain, inflammation); Other effect (candidal infection)
  • Prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (PTT) and/or hypoprothrombinemia (with or without bleeding) have been reported and occur most frequently with N-methylthiotetrazole side chain-containing cephalosporins
Special Instructions
  • May be taken with food to decrease gastric distress
  • Use with caution in patients with hypersensitivity reactions to cephalosporins, penicillins or other drugs and renal impairment

 
Cefadroxil 1-2 g/day PO divided 12-24 hourly
Cefalexin (Cephalexin) 250 mg PO 6 hourly or
500 mg PO 12 hourly or
1-4 g/day PO divided 6-12 hourly
Cefazolin 1 g IM/IV 12 hourly
Cefradine (Cephradine) 1-2 g/day PO divided 6-12 hourly
Max dose: 4 g/day or
2-4 g/day IM/IV divided 6 hourly
Max dose: 8 g/day
Second Generation
Cefaclor 250-500 mg PO 8 hourly
Max dose: 4 g/day
Extended-release: 375 mg PO 12 hourly or
500 mg PO 24 hourly
Cefamandole 500 mg IM/IV 8 hourly
Cefminox 2 g/day IV divided 12 hourly
Cefoxitin 1-2 g IM/IV 6-8 hourly
Cefuroxime 125-500 mg PO 12 hourly or
750 mg IM/IV 6-8 hourly or
1,500 mg IV 6-8 hourly
Third Generation
Cefdinir 100 mg or 300 mg PO 12 hourly
Cefditoren 200-400 mg PO 12 hourly or
400 mg PO 24 hourly
Cefixime 100-200 mg PO 12 hourly or
400 mg PO 24 hourly
Cefoperazone 2-4 g/day IM/IV divided 12 hourly
Cefotaxime 1 g IM/IV 12 hourly
Cefpodoxime 100-200 mg PO 12 hourly
Ceftazidime 500-1,000 mg IM/IV 12 hourly
Ceftibuten 400 mg PO 24 hourly
Ceftizoxime 500 mg IM/IV 12 hourly
Ceftriaxone 1-2 g IM/IV 24 hourly
Fourth Generation
Cefepime1 500-1,000 mg IM/IV 12 hourly
Cefiderocol 2 g IV 8 hourly
Cefpirome 1-2 g IV 12 hourly
Cephalosporins with Beta-lactamase Inhibitors
Cefepime/tazobactam 500-1,000 mg IV/IM 12 hourly x 7-10 days
Cefoperazone/sulbactam 2-4 g IM/IV 12 hourly in equally divided doses
Ceftazidime/avibactam 2.5 g in 100 mL IV infusion over 2 hours 8 hourly x 5-10 days (may extend up to 14 days in patients with bacteremia)
Ceftolozane/tazobactam 1.5 g IV infusion over 1 hour 8 hourly x 7 days
Ceftriaxone/sulbactam 1-2 g (Ceftriaxone) IM/IV 12-24 hourly
Cefuroxime/clavulanate 125 mg PO 12 hourly
1Combination with Arginine is available. Please see the latest MIMS for specific formulations and prescribing information.

Oestrogens, Progesterones & Related Synthetic Drugs

Drug Dosage Remarks
Estradiol Treatment of urogenital symptoms associated with postmenopausal vaginal atrophy:
To be inserted into the vagina until resistance is met
10 mcg vaginal tab 24 hourly x 2 weeks
Maintenance dose:
1 vaginal tab 2x/week		 Adverse Reactions
  • CNS effect (headache); GU effects (vaginitis, vaginal discomfort, vaginal bleeding, asymptomatic bacterial growth, UTI); GI effects (abdominal pain, nausea); Other effects (arthritis, hot flushes)
Special Instructions
  • Avoid use in patients with undiagnosed vaginal bleeding, untreated endometrial hyperplasia, history or suspected breast cancer, active deep vein thrombosis, pulmonary embolism, active or recent arterial thromboembolic disease
  • Use with caution in patients with hepatic impairment or history of cholestatic jaundice associated with previous estrogen use
  • Monitor patients with signs and symptoms of vaginal irritation, abnormal discharge, or bleeding
  • Discontinue use in patients with signs of ulceration or severe inflammation due to unresponsive atrophic vaginitis
Estriol1 Treatment of urogenital symptoms related to estrogen deficiency:
To be inserted into the vagina until resistance is met
1 application/day of 1 mg/g cream for the first few weeks followed by gradual reduction based on relief of symptoms
Maintenance dose:
1 application 2x/week
or
0.5-3 mg/day vaginal tab in a single dose for up to 1 month, followed by 0.5-1 mg/day until improvement of epithelium occurs (short-term use)		 Adverse Reactions
  • GI effects (nausea/vomiting, stomach cramps, cholestatic jaundice); Gynecologic effects (spotting, cervical hypersecretion, change in vaginal bleeding patterns, breast discomfort or pain); Other effects (irritation or itching at application site, edema, depression, hemorrhagic eruption, chloasma or melasma)
Special Instructions
  • Avoid in patients with known or suspected breast cancer, estrogen-dependent tumors, undiagnosed vaginal bleeding, untreated endometrial hyperplasia, thrombosis, thromboembolism, acute liver disease, porphyria
  • Use with caution in patients with leiomyoma, endometrial hyperplasia, first-degree heredity for breast cancer, hypertension, diabetes mellitus (DM), severe liver disorders, severe headache, systemic lupus erythematosus, epilepsy, asthma, otosclerosis, thromboembolic disorders
  • Discontinue use if jaundice or liver function deterioration occurs, significant increase in blood pressure or new onset of migraine-type headache occurs
1Combination with Lactobacillus acidophilus is available. Please see the latest MIMS for specific formulations and prescribing information.

Other Antibiotics

Drug Dosage Remarks
Diaminopyrimidine
Trimethoprim 100-200 mg PO 12 hourly or
200-300 mg PO 24 hourly		 Adverse Reactions
  • Dermatologic effects (morbiliform/maculopapular rash, pruritus, photosensitivity); GI effects (nausea/vomiting, epigastric distress, glossitis, abdominal pain); Hematologic effect (anemia); Renal effects (increased BUN and creatinine, hyperkalemia)
Special Instructions
  • Use with extreme caution or not at all in patients with hematological disorders especially megaloblastic anemia due to Folic acid deficiency
  • Use with caution in patients with renal impairment or severe hepatic dysfunction and folate deficiency (may consider administration of Folinic acid)
Nitrofuran
Nitrofurantoin 50-100 mg PO 6 hourly or
100 mg PO 12 hourly		 Adverse Reactions
  • GI effects (nausea/vomiting, abdominal pain, diarrhea, anorexia); CNS effects (dizziness, drowsiness, fatigue, headache); Hypersensitivity effects (rash, angioedema, SJS, exfoliative dermatitis, pancreatitis); Respiratory effect (acute pulmonary sensitivity reactions including pulmonary fibrosis); Neuromuscular effects (arthralgia, numbness, paresthesia, weakness); Ophthalmologic effects (amblyopia, nystagmus, optic neuritis)
Special Instructions
  • Take with food to decrease GI effects
    • Maintain adequate hydration (2-3 L/day of fluids) unless instructed to restrict fluid intake
  • Avoid in patients with renal impairment and glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Use with caution in the elderly and in patients with pre-existing pulmonary, hepatic, neurological or allergic disorders and in those with conditions (eg anemia, DM, electrolyte imbalance, debility or vitamin B deficiency) which may predispose to peripheral neuropathy
    • Discontinue if signs of peripheral neuropathy develop
Phosphonic Acid Derivative
Fosfomycin Acute uncomplicated cystitis in women: 3 g PO as single dose Adverse Reactions
  • GI effects (nausea, diarrhea, epigastric discomfort, anorexia, stomatitis); Dermatologic effects (rash, urticaria, erythema); CNS effects (headache, visual disturbances, dizziness)
Special Instructions
  • Take 1 hour before or 2 hours after meals
  • Use with caution in patients with severe renal failure
Polymyxin
Polymyxin B 15,000 to 25,000 U/kg/day IV divided 12 hourly Adverse Reactions
  • Renal effects (albuminuria, cylindruria); CNS effects (dizziness progressing to ataxia, drowsiness, peripheral paresthesias); Other effects (azotemia, rising serum drug levels without increasing dosage, facial flushing, drug fever, urticarial rash, pain at IM injection site and thrombophlebitis at IV injection site)
  • May cause overgrowth of non-susceptible organisms
Special Instructions
  • Avoid concurrent use of curariform muscle relaxant, other neurotoxic drugs and/or nephrotoxic drugs
  • Use with caution in patients with nephrotoxicity and renal impairment
  • Discontinue if with C difficile-associated diarrhea and paralysis appears
  • Requires baseline renal function prior to therapy with frequent monitoring

Other Beta-Lactams

Drug Dosage Remarks
Carbapenems
Biapenem 1.2 g/day IV infusion over 30-60 minutes divided 12 hourly Adverse Reactions
  • GI effects (diarrhea, nausea/vomiting, antibiotic-associated diarrhea/colitis, tongue/tooth discoloration, altered taste); Hypersensitivity effects (rash, anaphylaxis); CNS effects (mental disturbances, confusion; Imipenem/cilastatin: Seizures/convulsions have been reported especially in patients with history of CNS lesions and renal dysfunction); Other effect (candidal infections)
Special Instructions
  • Use with caution in patients allergic to penicillins, cephalosporins or other beta-lactams, with renal impairment and CNS disorders (eg epilepsy)
Doripenem 500 mg IV infusion over 60 minutes 8 hourly
Ertapenem 1 g IM/IV 24 hourly
Imipenem/cilastatin 250-500 mg IV 6 hourly or
1 g IV 6-8 hourly
Meropenem 250 mg IV 6 hourly or
500 mg IV 6-8 hourly or
1 g IV 8 hourly
Monobactam
Aztreonam 500-1,000 mg IM/IV 8-12 hourly Adverse Reactions
  • GI effects (nausea/vomiting, diarrhea, pseudomembranous colitis, GI bleeding); Hepatic effects (jaundice, hepatitis, increased liver enzymes); Other effects (PT and PTT prolongation, local reactions at infusion site, skin rash, pruritus)
Special Instructions
  • Use with caution in patients with history of beta-lactam hypersensitivity, renal and hepatic impairment

Other Drugs Acting on the Genito-Urinary System

Drug Dosage Remarks
Na bicarbonate/Na citrate/Citric acid/Tartaric acid Urinary alkalinization: Dissolve 4-8 g in water then take PO 6-8 hourly
Max duration of therapy: 5 days		 Adverse Reactions
  • GI effect (mild laxative); Other effects (systemic alkalosis/hypernatremia)
Special Instructions
  • Avoid in patients with renal failure or hypernatremia; in conjunction with hexamine mandelate or hexamine hippurate therapy; concomitant use of urinary alkalinizers and quinolone antibiotics
  • Use with caution in patients on low Na diet, with cardiac failure, hypertension, impaired renal function, peripheral and pulmonary edema and preeclampsia

Penicillins

Drug Dosage Remarks
Aminopenicillins with or without Beta-lactamase Inhibitors Adverse Reactions
  • Hypersensitivity effects (rash, urticaria, pruritus, anaphylaxis); GI effects (diarrhea, nausea/vomiting); Other effect (candidal infections)
  • High doses may be associated with CNS effects (encephalopathy, convulsions)
Special Instructions
  • Avoid in patients with Penicillin allergy
  • Use with caution in patients with renal impairment
  • Pivmecillinam: Associated with acute porphyria; possibility of pseudomembranous colitis if diarrhea occurs after administration and carnitine deficiency with long-term or repeated treatment
    • Avoid in patients with esophageal function disorder or genetic abnormalities as these are known to lead to severe carnitine deficiency
Amoxicillin
(Amoxycillin)		 250-500 mg PO 8 hourly or
500-875 mg PO 12 hourly or
3 g PO as single dose followed by 3 g PO after 8-12 hours
Amoxicillin/clavulanic acid
(Amoxicillin/clavulanate,
Co-amoxiclav)		 375-625 mg PO 8 hourly or 625-1,000 mg PO 12 hourly or
3 g PO repeated once after 10-12 hours
Ampicillin 250-500 mg PO 6-8 hourly or
500 mg IM/IV 6 hourly
Ampicillin/sulbactam
(Sultamicillin)		 375-750 mg PO 12 hourly or
1.5-12 g/day IM/IV divided 6-8 hourly
Bacampicillin 400-800 mg PO 8-12 hourly
Sultamicillin tosylate 375-750 mg PO 12 hourly
Antipseudomonal Penicillins with or without Beta-lactamase Inhibitors
Piperacillin 100-300 mg/kg/day IV divided 6-8 hourly
Piperacillin/tazobactam 3.375 g IV infusion 6 hourly or
4.5 g IV infusion 8 hourly
Max dose: 12 g Piperacillin/1.5 g tazobactam
Ticarcillin/clavulanic acid
(Ticarcillin/clavulanate)		 3.2 g IV infusion 4-6 hourly
Antistaphylococcal Penicillin
Cloxacillin 250-500 mg PO 6 hourly
Other Penicillins
Pivmecillinam 400 mg PO 8 hourly x 3-5 days or
200 mg PO 12 hourly x 7 days or
200 mg PO 8 hourly x 5 days or
400 mg PO followed by 200 mg PO 8 hourly x 8 doses

Quinolones

Drug Dosage Remarks
Ciprofloxacin 100-125 mg PO 12 hourly or
250-500 mg PO 12-24 hourly
Extended-release: 500 mg PO 24 hourly x 3 days		 Adverse Reactions
  • GI effects (nausea/vomiting, diarrhea, abdominal pain, dyspepsia, diarrhea); CNS effects (headache, dizziness, sleep disorders, restlessness, drowsiness); Dermatologic effects (rash, pruritus, photosensitivity); Hypersensitivity effects (rash, SJS)
  • Some quinolones have the potential to prolong the QT interval
Special Instructions
  • Administer at least 2 hours before or 3 hours after Al- or Mg-containing antacids, dietary supplements containing Zn or Fe or buffered Didanosine preparations
  • Avoid exposure to strong sunlight or tanning beds
  • Use with caution in patients with epilepsy or history of CNS disorders, impaired renal or hepatic function and G6PD deficiency
Levofloxacin 250-500 mg PO 12-24 hourly
Lomefloxacin 400 mg PO 24 hourly x 3 days
Norfloxacin 200-400 mg PO 12 hourly
Ofloxacin 100 mg PO 12 hourly or
200 mg PO 12-24 hourly
Pefloxacin 800 mg PO as single dose
Pipemidic acid 400 mg PO 12 hourly
Prulifloxacin 200-300 mg PO 12 hourly or
600 mg PO as single dose
Rufloxacin 400 mg PO on day 1 followed by 200 mg PO 24 hourly x 5 days
Sitafloxacin 50 mg PO 12 hourly or
100 mg PO 24 hourly x 3 days
May be increased to 100 mg PO 12 hourly

Tetracyclines

Drug Dosage Remarks
Doxycycline 100 mg PO 12 hourly or
200 mg PO on day 1 followed by 50 mg PO 12 hourly or 100 mg PO 24 hourly
Max dose: 200 mg/day		 Adverse Reactions
  • GI effects (nausea/vomiting, diarrhea); Other effects (photosensitivity, benign intracranial hypertension, increased BUN, anorexia, neutropenia)
Special Instructions
  • Avoid exposure to excessive sunlight or UV radiation
  • Contraindicated in patients hypersensitive to tetracyclines; concomitant use with retinoids
  • Use with caution in patients with hepatic or renal impairment, myasthenia gravis, SLE
Minocycline 100-200 mg PO on day 1 followed by 100 mg PO 12 hourly or 50 mg PO 6 hourly
Max dose: 400 mg/day
Tetracycline 250 mg PO 6 hourly or
500 mg PO 12 hourly

Disclaimer

All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.  
Not all products are available or approved for above use in all countries.  
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.   
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.  

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