Urinary tract infection (lower): antimicrobial prescribing

Medicines adherence may be a problem for some people with medicines that require frequent dosing or longer treatment duration (for example, some antibiotics). See the NICE guideline on medicines adherence.

There is a potential resource saving if a back-up antibiotic prescription strategy is used in non-pregnant women with lower urinary tract infection (UTI).

Recommended antibiotics (nitrofurantoin, trimethoprim, amoxicillin, cefalexin and fosfomycin) are available as generic formulations, but there is currently no generic formulation of pivmecillinam, although the cost is comparable to other generic antibiotics, see Drug Tariff for costs.

Nitrofurantoin 25 mg/5 ml oral suspension is more expensive than other oral suspensions, such as trimethoprim 50 mg/5 ml. The cost of a 300-ml bottle of nitrofurantoin is £446.95 compared with £4.87 for a 100-ml bottle of trimethoprim (Drug Tariff, September 2018).