Choosing Right Antibiotics for UTI: A Guide to Effective Treatment

Urinary tract infection (UTI) is a health concern that can cause discomfort and distress.

When bacteria enter the urinary tract, they can lead to symptoms such as pain, frequent urination, and a burning sensation. 

Fortunately, antibiotics have proven highly effective in treating UTIs by targeting the underlying bacterial infection. 

In this article, we will learn about various antibiotics for UTI treatment.

We will also understand how antibiotics work and their significance in resolving UTIs.

Antibiotics for uncomplicated UTIs

Individuals with properly functioning urinary tracts and no increased susceptibility to UTI are known as uncomplicated urinary tract infections.

In such cases, antibiotics are considered the first line of treatment.

The course and type of prescribed antibiotic for UTI depends on the kind of bacteria detected in your urine.

Following are some of the antibiotics for uncomplicated UTI:

Nitrofurantoin

This antibiotic medication is taken for five days.

It is sold under the brand name Macrodantin and Macrobid.

Unlike other treatments, Nitrofurantoin has very low chances for antibiotic resistance and has an 83 to 93% cure rate.

Trimethoprim-Sulfamethoxazole

This medicine is sold under the brand name Bactrim and Septra.

It is also known as co-trimoxazole or TMP-SMX.

This treatment is a combination of two antibiotics and is used for three days.

Trimethoprim-Sulfamethoxazole is the best antibiotic for UTIs, but resistance to this medicine is increasing.

Fosfomycin

Fosfomycin is sold as an oral solution packed in sachets under the brand name Monural Granules.

This one-day antibiotic treatment for UTIs has a cure rate of around 83 to 90 percent. 

However, a clinical study conducted in 2018 found that Nitrofurantoin is more effective than this treatment. 

Fosfomycin, the antibiotic used in this treatment, can lead to an increase in antibiotic resistance.

Fluoroquinolones

Following are the medicines that come under the category of Fluoroquinolones:

These antibiotics are highly effective for treating urinary tract infections.

However, it’s essential to know that these antibiotics are only prescribed when no other treatment options are available.

These medications can risk your mental health and cause low sugar levels.

Antibiotics for complicated UTIs

UTIs are considered complicated when:

• you are pregnant
• urinary tract abnormalities are present
• the patient is a child
• you are elderly
• you are a man (most UTIs in men are considered complicated)

If you are suffering from a complicated UTI, the doctor will prescribe you a different course of antibiotics.

Moreover, follow-up urine tests are recommended within 10 to 14 days after the treatment.

Some medicines which are considered appropriate are as follows:

Fluoroquinolones

Specifically, Ciprofloxacin and Levaquin are recommended in case of complicated UTIs.

This medicine offers rapid oral absorption and high tissue concentration.

These also have broad activity against most Gram-positive and Gram-negative organisms.

Trimethoprim-Sulfamethoxazole

This medicine is considered an effective antibiotic treatment for UTIs in men.

It works by the elimination of the microbes responsible for various types of infections.

Vabomore

It is FDA-approved for UTI treatment in adults. 

It contains Meropenem (Antibacterial) and vaborbactam, which inhibit the resistance mechanism used by bacteria

Fetroja

It is also an antibacterial medicine approved by the FDA for treating complicated UTIs and kidney infections.

Fetroja showed safety and effectiveness in a study of 448 patients with UTIs.

72.6% of patients who received Fetroja experienced symptom resolution and bacterial eradication after seven days of treatment.

Recarbrio

It is an FDA-approved antibacterial for the treatment of complicated UTIs.

Recarbrio is an injection that combines three drugs: imipenem-cilastatin, relebactam, and a new inhibitor of beta-lactamase.

Treatment for recurrent UTIs

Recurrent infections are defined as three or more UTIs that occur within a year.

These are not treated the same as standalone UTIs.

One reason is that continued antibiotic courses may lead to allergic reactions, organ toxicities, future infections, and more.

Generally, antibiotics are prescribed as the first line of treatment for UTI.

These treatments include antibiotics for UTIs like Nitrofurantoin, TMP-SMX, and Fosfomycin as the primary choice.

Nonetheless, the particular medication suggestions should rely upon the local antibiogram. 

An antibiogram is a periodic overview of antimicrobial susceptibilities that assists in tracking drug resistance.

Still, if you face UTIs, then your doctor may recommend you the following for UTI treatment:

• Repeated testing: If the symptoms of UTI still persist after antimicrobial therapy, you should go for a urinalysis. Urine culture and antibiotic susceptibility testing can help guide further management
• Vaginal Estrogen: For women in the peri and post-menopausal phase with recurrent UTIs, vaginal Estrogen therapy is prescribed to reduce the risk of future infection

Conclusion

Antibiotics for UTIs are considered the primary treatment for UTIs.

For uncomplicated UTIs, options include Nitrofurantoin, Trimethoprim-sulfamethoxazole, and Fosfomycin. 

Fluoroquinolones such as Ciprofloxacin and Levofloxacin are the last option for uncomplicated UTIs. 

Complicated UTIs may require different antibiotics like Ciprofloxacin and Trimethoprim-Sulfamethoxazole. 

Recurrent UTIs may need initial treatments and further testing, with vaginal Estrogen therapy for some women. 

Consult your healthcare professional for proper diagnosis and guidance.

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