Is a short course of Keflex for treatment of uncomplicated UTI as effective as a longer course?

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I have a 14 y/o female with dysuria and pelvic cramping for 2 days. No vaginal or urinary bleeding. No menarche. Pt is not sexually active. Pt does not have any fever, nausea, vomiting or flank pain. No significant history of recurrent UTIs in the past.

Point of care UA shows moderate leukocyte esterase and positive nitrites.

Assuming this is a UTI, Keflex treatment recommendation is 7-14 days. Is a 7 days course adequate and effective for this patient, compared to a longer duration?

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Yes, a shorter course of antibiotics is as effective as a longer course. A pretty good review of systematic reviews [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390420/] looked at several types of routine outpatient infections (pharyngitis, community acquired pneumonia, otitis media, UTI, etc.) and found that shorter courses were as effective as longer courses.


There are several obvious benefits such as reduced costs and improvement in patient compliance rate.


https://pubmed.ncbi.nlm.nih.gov/12137628/


https://pubmed.ncbi.nlm.nih.gov/29590188/

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