University of Michigan Guideline Utilization, Implementation,
Health System Development, and Evaluation Studies
300 North Ingalls, Room 7B10 Phone: (734) 936-9771
Ann Arbor, Michigan 48109-0485 Fax: (734) 615-0062
June 21, 2005
To: Family Physicians, General Internists, Primary Care Obstetricians/Gynecologists, Adult Primary Care
From: GUIDES (Guideline Utilization Implementation Development and Evaluation Studies)
Connie Standiford, MD, GUIDES Lead
Van Harrison, PhD, GUIDES Co-Lead
Lee Green, MD, MPH, Guideline Development Clinical Lead
Subject: UMHS Clinical Care Guideline Update: Urinary Tract Infection (’05 update)
The updated UMHS clinical care guideline “Urinary Tract Infection” has been sent electronically to health care
When resistance rates are less than 10-20%, TMP/SMX remains the most cost-effective therapy.
Recommending alternative forms of contraception is not necessary when prescribing antibiotics for
UTI in women using oral contraceptives (OCPs).
Some studies have shown that cranberry juice or cranberry tablets can significantly reduce the annual
incidence of UTIs in sexually active women with a history of UTIs.
The template “Ambulatory Nursing: Urinary Tract Infection, Non-Pregnant Adult” is available
through CareWeb or link directly to:
TraceVue OB record will include documentation of UTI in pregnant women.
Pretreatment cultures are rarely necessary for uncomplicated UTI.
Consider telephone management for uncomplicated UTI in women with previous UTI.
With stable rates of resistance in our community (15%-16%), TMP/SMX remains the drug of first
choice in uncomplicated UTI in women. Three days of treatment with Bactrim or Cipro (7 days of
macrobid or amoxicillin) is usually sufficient for uncomplicated UTI.
Follow up cultures or urinalysis are not usually necessary.
The template “Ambulatory Nursing: Urinary Tract Infection, Non-Pregnant Adult” is available on:
Patient Education: http://www.med.umich.edu/1libr/guides/utif.htm
UMHS Clinical Care Guidelines: http://www.med.umich.edu/i/oca/practiceguides/