What is the treatment for a urinary tract infection (UTI)?
Treatment for a UTI should be designed for each patient individually and is usually based on the patient's underlying medical conditions, what pathogen(s) are causing the infection, and the susceptibility of the pathogen(s) to treatments. Patients who are
very ill usually require intravenous (IV) antibiotics and admission to a hospital; they usually have a kidney infection (pyelonephritis) that may be spreading to the bloodstream. Other people may have a milder infection (cystitis) and may get well quickly with oral
antibiotics. Still others may have a UTI caused by pathogens that cause STDs and may require more than a single oral antibiotic.
The caregivers often begin treatment before the pathogenic agent and its antibiotic susceptibilities are known, so in some individuals, the antibiotic treatment may need to be changed. In addition, pediatric patients and pregnant patients should not use
certain antibiotics that are commonly used in adults. For example, ciprofloxacin (Cipro) and other related quinolones should not be used in children or pregnant patients due to side effects. However, penicillins and cephalosporins are usually considered safe for both groups if the individuals are not allergic to the antibiotics. Patients with STD-related UTIs usually require two antibiotics to
eliminate STD pathogens. The less frequent or rare fungal and parasitic pathogens require specific antifungal or antiparasitic medications; these more complicated UTIs should often be treated in consultation with an infectious disease expert.
All antibiotics prescribed should be taken even if the person's symptoms disappear early. Reoccurrence of the UTI and even antibiotic resistance of the pathogen may happen in individuals who are not adequately treated.
Over-the-counter (OTC) medicines offer relief from the pain and discomfort of UTIs but they don't cure UTIs. OTC products like AZO or Uristat contain the medicine, phenazopyridine (Pyridium and Urogesic), which works in the bladder to relieve pain. This medication turns urine an orange-red color, so patients should not be worried when this occurs. This medication can also turn other body fluids orange, including tears, and can stain contact lenses.
What are common antibiotics used to treat a urinary tract infection (UTI)?
The following antibiotics are used to treat UTIs:
Beta-lactams, including penicillins and cephalosporins (for example, Amoxicillin, Augmentin, Keflex, Duricef, Ceftin, Lorabid, Rocephin, Cephalexin, Suprax, and others); many organisms have resistance to some of these drugs.
Trimethoprim-sulfamethoxazole combination antibiotic (for example, Bactrim DS and Septra); many organisms may show resistance.
Fluoroquinolones (for example, Cipro, Levaquin, and Floxacin) resistance is developing; also these should not be used in pregnancy or in the pediatric population.
Tetracyclines (for example, tetracycline, doxycycline, or minocycline) used most often for Mycoplasma or Chlamydia infections; like fluoroquinolones, they should not be used in pregnancy or by the pediatric population.
Aminoglycosides (for example, gentamycin, amikacin, and tobramycin) used usually in combination with other antibiotics to combat severe UTIs.
Macrolides (for example, clarithromycin, azithromycin, and erythromycin), used more often with some STD-caused urinary problems.
There are other antibiotics that are used occasionally, such as Nitrofurantoin, but its use is limited to cystitis and should not be used to
treat more serious (kidney) UTIs. Choice of antibiotics for treatment depends mainly on the susceptibility of the infecting agent to the drug, the seriousness of the infection, if the infected person is an adult, child or is pregnant, and on the treating doctor's experience and knowledge of local antibiotic resistance patterns of commonly infecting bacteria.