Protocol for treatment of typical urinary tract infection: criteria for antimicrobial selection

Criteria for selecting an appropriate drug for treatment of urinary tract infection are based on therapeutic goals. A major criterion is to choose an antimicrobial that will not affect the patient's fecal and vaginal flora. Low cost is another important criterion. It is unnecessary to select an expensive antimicrobial when highly effective agents are available at low cost. High urinary concentration is the third goal of therapy and a major criterion for selecting an appropriate drug. To apply these selection criteria in clinical practice, use a criteria-based classification. Choose the agent highest on the following lists for which the patient shows no sensitivity: Class I, nitrofurantoin macrocrystals and penicillin VK; Class II, carbenicillin; Class III, amoxicillin; Class IV, trimethoprim-sulfamethoxazole and cephalosporins; Class V, ampicillin, tetracycline, norfloxacin.