Ceftriaxone at Day 3 for Cystitis

is admitted to the and found to have cystitis but no flank pain. HCG is negative. She is started on ceftriaxone

At day 3, vitals are stable and symptoms have resolved. Her urine culture grew pan-susceptible E. coli

What is the BEST antibiotic plan?

A. Discontinue
B. De-escalate
C. Escalate

How did others respond?

Reveal the answer

Best Answer:

Discontinue

Explanation: 2010 IDSA guidelines recommend 3-7 days of beta-lactams for treatment of uncomplicated cystitis.

One retrospective study comparing patients who received 3 days of ceftriaxone vs 6 day courses found NO DIFFERENCE in length of stay or recurrence 🎉

If symptoms are ongoing, a longer course may be warranted. If patients are stable and feeling well, 3 days of ceftriaxone for uncomplicated cystitis is appropriate!