Lower UTI in Pregnancy

Comments from Expert Advisory Committee

  • Send MSU for culture.
  • Nitrofurantion- should be avoided after 36 weeks due to risk of neonatal haemolysis.
  • Refer to local resistance patterns for empiric therapy where available and refer to MSU results. Amoxicillin resistance is common – only use if susceptibility data available.
  • Review empirical treatment with results of MSU culture and susceptibility.
  • Note guidelines on Asymptomatic Bacteriuria in Pregnancy
  • If acute pyelonephritis is suspected, consider referral to hospital. Consider acute pyelonephritis/ upper UTI when:
    • Pain in the loin which radiates to the iliac fossa and suprapubic area.
    • Sudden onset general systemic disturbance with fever, rigors, vomiting.
    • Tenderness and guarding over the kidney.



*Seek specialist/microbiologist advice in case of penicillin allergy in pregnant patients if nitrofurantoin is not an option.

Patient Information

Safe Prescribing (visit the safe prescribing page)

Reviewed November 2021

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