How should I treat children over 3 years of age with a lower urinary tract infection (cystitis)?
• Treat with an oral antibiotic for 3 days. • Consider trimethoprim, nitrofurantoin, cefalexin or amoxicillin, while taking local bacterial sensitivity patterns into account (this is an off licence use of nitrofurantoin as the summary of product characteristics specifies 7 days). • Note: avoid using broad spectrum antibiotics (e.g. cephalosporins) when narrow spectrum antibiotics are effective, as they increase the risk of Clostridium difficile, MRSA, and resistant UTIs. • Treat pain with paracetamol — avoid NSAIDs. • Encourage (and monitor) adequate fluid intake.
