What is the first line treatment for Acute Uncomplicated Cystitis?

The first-line treatment for acute uncomplicated cystitis typically includes nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin. These antibiotics are specifically chosen for their effectiveness against the common pathogens that cause urinary tract infections, particularly Escherichia coli.

Nitrofurantoin is favored due to its specific action in the urinary tract and its low propensity to cause resistant strains of bacteria. TMP-SMX is another effective option, although resistance rates need to be considered for its use. Fosfomycin offers a single-dose option that is convenient for patients.

In contrast, other choices like intravenous ciprofloxacin, oral azithromycin, and intravenous gentamicin, while effective for various infections, are not typically utilized as first-line treatments for uncomplicated cystitis. Such options may be reserved for more severe infections or specific circumstances where first-line agents are contraindicated or ineffective. Thus, the selection of nitrofurantoin, TMP-SMX, or fosfomycin aligns with established guidelines for treating uncomplicated cystitis.