Uncomplicated cystitis in a non-pregnant woman can be treated empirically. But when symptoms recur, fail to settle, or the patient has had recent antibiotics, send a midstream urine for culture and sensitivity before starting a different agent.
The result guides the next choice, documents resistance for future episodes, and avoids reaching for a broad-spectrum or newer drug when a first-line one would still work.
- Treat a first uncomplicated cystitis empirically according to local guidance.
- Send culture for recurrence, treatment failure or recent antibiotic use.
- Record resistance results where future prescribers will see them.
- Use culture results to step down to the narrowest effective agent.
Why it matters
Newer oral agents are only worth having if they are kept for the infections that need them.
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