There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Treatment for Streptococcal (Strep) Urinary Tract Infection (UTI)
- The treatment for Streptococcal (Strep) UTI typically involves antibiotic therapy, with the choice of antibiotic depending on the specific strain of Streptococcus and the patient's individual circumstances 1, 2.
- For Streptococcus agalactiae, high in vitro sensitivity has been reported to ampicillin, augmentin, cephalothin, lincomycin, chloramphenicol, and erythromycin, as well as 100% sensitivity to rifampicin 1.
- Beta haemolytic group A streptococci causing UTI have been shown to respond well to antimicrobial therapy 2.
- In general, the treatment of UTIs, including those caused by Streptococcus, should be guided by the results of urine culture and susceptibility testing, as well as the patient's clinical presentation and medical history 3, 4.
- First-line treatments for UTI include nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole (when resistance levels are <20%), which have minimal collateral damage and resistance 3.
- In cases where the probability of UTI is moderate or unclear, urine culture should be performed to guide treatment 3.
Special Considerations
- Patients with Streptococcal UTI may have underlying conditions that predispose them to infection, such as urinary tract catheterization or nephrourological malformations 2, 5.
- In patients with recurrent UTI or those with atypical pathogens, such as Streptococcus pneumoniae, imaging studies of the urinary tract may be necessary to identify underlying abnormalities 5.