Patients who are well appearing, have stable vital signs, are able to maintain oral hydration and comply with oral therapy, and have no significant comorbid conditions can be treated as outpatients, with adequate follow-up arranged in 48-72 hours.
Adult males with UTI should receive a 10- to 14-day course of antibiotics. Outpatient regimens include a fluoroquinolone, trimethoprim-sulfamethoxazole (TMP-SMZ), minocycline, or nitrofurantoin (should not be given if glomerular filtration rate < 50 mL/min per 1.73 m2). Treat the symptom of dysuria with phenazopyridine.
Unfortunately, the prevalence of uropathogens resistant to TMP-SMZ, nitrofurantoin, and first-generation cephalosporins has continued to rise. There are data that suggest overall resistance to TMP-SMZ is approximately 25% (range, 10-45%), based on the area of the country, and resistance to nitrofurantoin is slightly higher. Although studies have indicated that resistance to fluoroquinolones has been acceptably low, more recent microbiologic data suggest that fluoroquinolone resistance, particularly on the West Coast, may be an increasing problem. Despite these concerns, fluoroquinolones remain the preferred initial drug therapy.
For more the treatment of UTIs in males, read here.
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Cite this: Bradley Schwartz. Fast Five Quiz: Are You Familiar With Urinary Tract Infections in Males? - Medscape - May 02, 2016.
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