Nitrofurantoin

• Modified-release capsules 100mg (£9.50 = 14 pack)
• Tablets 100mg (£11.52 = 28 pack)
• Oral suspension sugar free 25mg/5ml (£448.63 = 300ml bottle)

Indications

• UTI (lower)
  • Non-pregnant women and men aged 16 years and over
  • Pregnant women ≥12 years
  • Children and young people aged 3 months to 16 years
• Recurrent UTI in non-pregnant women
• Catheter-associated UTI (see note 2)
  • Non-pregnant women and men aged 16 years and over with no upper UTI symptoms

Notes

1. Nitrofurantoin suspension is significantly more expensive than tablets and capsules, and should be avoided unless other options are not appropriate
2. Catheter must be removed prior to treatment and not reinserted

Fosfomycin

• Sachets 3g (£4.86 = 1 sachet)
• Injection 2g, 4g

Indications

• UTI (lower) in adults
  • Non-pregnant women and men aged 16 years and over
• Community multi-resistant UTIs

Notes

1. Doses should be taken preferably before bedtime and after emptying the bladder

Methenamine hippurate

• Tablets 1g (£16.74 = 60 tablets)

Indications

• Prophylaxis and long-term treatment of chronic or recurrent uncomplicated lower urinary-tract infections

Notes

1. Methenamine hippurate is to be considered after alternative formulary options have been used or if they are not suitable
2. Methenamine hippurate requires an acidic urine for its antimicrobial activity - specialists will advise patients how to maintain acidic urine
3. Avoid if eGFR less than 10 mL/minute/1.73 m² – risk of hippurate crystalluria