From the FDA Drug Label
Levofloxacin tablets are indicated for the treatment of uncomplicated urinary tract infections (mild to moderate) due to Escherichia coli, Klebsiella pneumoniae, or Staphylococcus saprophyticus. The recommended treatment for Staphylococcus saprophyticus infections is levofloxacin (PO), as it is indicated for the treatment of uncomplicated urinary tract infections due to this bacterium 1.
- Key points:
- Levofloxacin is effective against Staphylococcus saprophyticus.
- It is used to treat uncomplicated urinary tract infections caused by this bacterium.
From the Research
The recommended treatment for Staphylococcus saprophyticus infections is a course of oral antibiotics, with first-line treatment usually involving trimethoprim-sulfamethoxazole (TMP-SMX) or nitrofurantoin, as these antibiotics have been shown to be effective against S. saprophyticus in recent studies 2.
Key Considerations
- The choice of antibiotic should be guided by local resistance patterns and patient-specific factors, such as pregnancy or allergy history.
- Fluoroquinolones, such as ciprofloxacin, can be used as alternatives, but are generally reserved for cases where first-line agents cannot be used due to resistance concerns.
- Patients should complete the full course of antibiotics, even if symptoms improve quickly, and drink plenty of fluids to help flush the bacteria from the urinary tract.
Antibiotic Options
- Trimethoprim-sulfamethoxazole (TMP-SMX): 160/800 mg twice daily for 3 days
- Nitrofurantoin: 100 mg four times daily for 5-7 days
- Ciprofloxacin: 250 mg twice daily for 3 days (alternative option)
Special Considerations
- For pregnant patients, nitrofurantoin or cephalexin 500 mg four times daily for 5-7 days are preferred options.
- Patients should seek follow-up care if symptoms persist beyond 48-72 hours of treatment, which might indicate antibiotic resistance requiring culture-guided therapy.
Evidence Summary
The most recent study 2 found that trimethoprim, trimethoprim/sulfamethoxazole, and nitrofurantoin remain effective against S. saprophyticus, with high susceptibility rates (97%, 98%, and 100%, respectively). Methicillin resistance was the most common form of urinary antibiotic resistance, but was still relatively low at 5.6%. These findings support the use of TMP-SMX and nitrofurantoin as first-line treatments for S. saprophyticus infections.