1. Guidelines for antimicrobial therapy of urinary tract infections in Taiwan Infectious Diseases Society of the Republic of China, Medical foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, Lee CY ’ s Research Foundation for Pediatric Infectious Diseases and Vaccine 2000;33:271-272 J Microbiol Immunol Infect

2. A consensus conference for establishing guidelines for antimicrobial therapy of urinary tract infections in Taiwan was held on March 11, 2000, following a symposium on urinary tract infections(UTIs) held in conjunction by the Infectious Diseases Society of the Republic of China(IDSROC), A consensus conference for establishing guidelines for antimicrobial therapy of urinary tract infections in Taiwan was held on March 11, 2000, following a symposium on urinary tract infections(UTIs) held in conjunction by the Infectious Diseases Society of the Republic of China(IDSROC), the Medical Foundation in Memory of Dr. Deh-Lin Cheng, the Medical Foundation in Memory of Dr. Deh-Lin Cheng,

3. Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and Lee CY ’ s Research Foundation for Pediatric parties to this consensus conference included board members of the IDSROC, and Lee CY ’ s Research Foundation for Pediatric parties to this consensus conference included board members of the IDSROC, and experts in the field of infectious disease. experts in the field of infectious disease.

4. This is the second consensus conference of this nature, and abided b the three principles established during the first consensus conference on antimicrobial therapy of pneumonia in Taiwan, held in 1999: This is the second consensus conference of this nature, and abided b the three principles established during the first consensus conference on antimicrobial therapy of pneumonia in Taiwan, held in 1999: 1.Establishment of guidelines from the viewpoint of primary care physicians. 2.Antimicrobial agents recommended in the guidelines were agents already marked in Taiwan. 3.Guidelines were based on academic principles rather than the regulations of the Bureau of Natonal Health Insurance on antibiotic usage.

5. In addition, the following two points were also considered: In addition, the following two points were also considered: 1.Guidelines were tailored to the local epidemiology, including commonly seen pathogens and antimicrobial resistance patterns. 2.Guidelines included recommendations on prophylactic antimicrobial usage.

6. Treatment guidelines were passed through the board of IDSROC, and a copy was sent to primary care physicians, in the hope fensuring appropriate use of antimicrobial agents in the community. Treatment guidelines were passed through the board of IDSROC, and a copy was sent to primary care physicians, in the hope fensuring appropriate use of antimicrobial agents in the community. These treatment guidelines were published as a supplement in the Journal of Immunology, Microbiology and Infection, to serve as a reference to all practicing physicians in Taiwan. These treatment guidelines were published as a supplement in the Journal of Immunology, Microbiology and Infection, to serve as a reference to all practicing physicians in Taiwan.

7. Guidelines for antimicrobial therapy of urinary tract infections DiagnosisDrug of choiceAlternative choice Asymptomatic bacteriuria Nitrofurantoin 1 o or 2 o cephalosporins Trimethoprim b Trimethoprim/sulfamethoxazole b Ampicillin or amoxicillin c Ampicillin/sulbactam c amoxicillin/clavulanate c Acute bacterial cystitis Nitrofurantoin 1 o or 2 o cephalosporins Trimethoprim Trimethoprim/sulfamethoxazole b Quinolones d Ampicillin or amoxicillin c Ampicillin/sulbactam c Amoxicillin/clavulanate c Fluoroquinolones e

8. DiagnosisDrug of choiceAlternative choice Acute uncomplicated pyelonephritis Trimethoprim/sulfametho xazole 1 o or 2 o cephalosporins Aminoglycosides Ampicillin or amoxicillinc Ampicillin/sulbactamc Amoxicillin/clavulanatec Aminoglycosides(single)+ 1 o or 2 o cephalosporins Acute complicated pyelonephritis/ emphysematous pyelonephritis/renal and perinephric abscess 1 o or 2 o cephalosporins or ampicillin or amoxicillin±Aminoglycos ides Trimethoprim/sulfametho xazole 3 o or 4 o cephalosporins Ticarcillin/clavulanate Piperacillin/tazobactam Aztreonam Imipenem or meropenem Fluoroquinolonese Guidelines for antimicrobial therapy of urinary tract infections

9. Diagnosis Drug of choice Alternative choice Acute bacterial prostatitis Ampicillin or amoxicillin 3 o cephalosporins Trimethoprim/sulfamethoxa zole Fluoroquinolones e Chronic bacterial prostatitis Trimethoprim/sulfamethoxa zole Fluoroquinolones

10. Diagnosis Drug of choice Alternative choice Nosocomial/catheter- related UTIs 3 o or 4 o cephalosporins Ureidopenicillins Fluoroquinolones e Ampicillin or amoxicillin f ± Aminoglycosides Imipenem or meropenem UTIs in pregnancyAmpicillin or amoxicillin c Nitrofurantoin 1 o or 2 o cephalosporins 3 o or 4 o cephalosporins Ureidopenicillins

11. Diagnosis Drug of choice Alternative choice UTIs in childrenAmpicillin or amoxicillinc or 1 o or 2 o cephalosporins + Aminoglycosides Trimethoprim/sulfamethoxa zole 3 o or 4 o cephalosporins Suppressive recurrent UTIs Nitrofurantoin Trimethoprim Trimethoprim/sulfamethoxa zole

12. Consensus Conference Participants (in alphabetical order): Consensus Conference Participants (in alphabetical order): Feng-Yee Chang, Shan-Chwen Chang, Yao-Shen Chen, Ming-Yuan Chou, Mong-Ling Chu, Chang- Phone Fung, Wei-Chuan Hsieh, Po-Ren Hsueh, Clement C.S. Hsu, Cheng-Hua Huang, Fu-Yuan Huang, Kun-Yen Huang, Yhu-Chering Huang, Chien-Ching Hung, Kao-Pin Hwang, Chi-Kan Lan, Yeu-Jan Lau, Cheng-Yi Liu, Ching-Chuan Liu, Yung-Ching Liu, Kwen-Tay Luh, Fu-Der Wang, Lih-Shinn Wang, Wing-Wai Wong, Muh-Yong Yen, Kwok-Woon Yu. Feng-Yee Chang, Shan-Chwen Chang, Yao-Shen Chen, Ming-Yuan Chou, Mong-Ling Chu, Chang- Phone Fung, Wei-Chuan Hsieh, Po-Ren Hsueh, Clement C.S. Hsu, Cheng-Hua Huang, Fu-Yuan Huang, Kun-Yen Huang, Yhu-Chering Huang, Chien-Ching Hung, Kao-Pin Hwang, Chi-Kan Lan, Yeu-Jan Lau, Cheng-Yi Liu, Ching-Chuan Liu, Yung-Ching Liu, Kwen-Tay Luh, Fu-Der Wang, Lih-Shinn Wang, Wing-Wai Wong, Muh-Yong Yen, Kwok-Woon Yu.

13. Dosage of Quinolones in Patients with normal and reduced renal function Norrnal Renal Function QuinoloneOralIntravenous Nalidixic acid500-1000mg q6h － Cinoxacin250mg q6h － Norfloxacin400mg q12h － Ciprofloxacin250-750mg q12h200-400mg q12h Ofloxacin200-400mg q12h Pefloxacin400mg q12h

14. Dosage of Quinolones in Patients with normal and reduced renal function Norrnal Renal Function QuinoloneOralIntravenous Enoxacin200-400mg q12h － Lomefloxacin400mg q24h － Sparfloxacin 400mg loading dose ， then 200mg q24h － Levofloxacin500mg q24h Grepafloxacin400-600mg q24h － Trovafloxacin200-300mg q24h

15. Available  -lactamase inhibitors and  -lactam antibiotic combinations

16. The major Cephalosporins