Selection of antibiotics should be tailored to the typical organisms and severity of illness.

In CA-UTI with severe symptoms, start broad-spectrum antibiotics (see chart below). Then narrow based on culture and sensitivities

In CA-UTI with mild symptoms:

• Review previous organisms and susceptibilities – typically covers 75% of cases
• If not available, use local antibiogram to guide therapy with guidance from chart below

Typical microbiology to consider coverage in absence of prior culture data (per IDSA CA-UTI guidelines – Microbiology):

• Escherichia coli (most common)
• Enterobacteriaceae species:
  • Klebsiella species
  • Serratia
  • Citrobacter species
  • Pseudomonas aeruginosa
• Gram positive cocci:
  • Coagulase-negative staphylococci
  • Enterococcus species