Medicine for Urinary Tract Infection: Antibiotics, Pain Relief

Oral antibiotics are the main method to treat UTIs. They are the most common and convenient way to administer antibiotics for UTIs.

First-line antibiotics

Fosfomycin (Monurol) is a single-dose antibiotic for uncomplicated UTIs resulting from certain bacteria, including E. coli.

Trimethoprim/sulfamethoxazole (Bactrim), also called co-trimoxazole, is a sulfonamide that often treats more severe UTIs. However, this antibiotic may harm beneficial bacteria in your body. Additionally, resistance to this antibiotic is increasing.

Trimethoprim/sulfamethoxazole may effectively treat recurrent UTIs over an extended period. This antibiotic isn’t safe for use during pregnancy or while nursing. The typical treatment duration is 14 days.

First-generation cephalosporins such as cephalexin (Keflex) have a high urine excretion rate, which enhances their effectiveness for UTIs. Doctors often prescribe cephalosporins to people with penicillin allergies.

Cephalosporins are generally safe during pregnancy. However, you should avoid cephalosporins while nursing. The typical treatment duration is 7 days.

Nitrofurantoin (Macrodantin, Macrobid) is suitable for treating simple UTIs. Healthcare professionals commonly prescribe it as a prophylactic antibiotic.

Nitrofurantoin slows bacterial growth instead of directly killing them, increasing the likelihood of your immune system naturally resolving the infection.

If you’re pregnant or nursing, consult a healthcare professional about the safety of using nitrofurantoin. Avoid taking it after 38 weeks of pregnancy. Usually, the treatment lasts 7 days.

Second-line antibiotics

Amoxicillin/potassium clavulanate (Augmentin) is a type of β-lactam antibiotic with a dual mechanism of action.

Amoxicillin directly attacks bacteria, while potassium clavulanate, a β-lactamase inhibitor, blocks the enzymes that break down amoxicillin, helping to prevent resistance.

If you’re pregnant or nursing, consult a healthcare professional about its safety.

Fluoroquinolones like ciprofloxacin (Cipro) are a type of quinolone antibiotic often useful for complicated UTIs and prostate infections.

Fluoroquinolones are linked with antimicrobial resistance, so only take them if essential.

Fluoroquinolones are not recommended for children or people with heart problems. Avoid fluoroquinolones during pregnancy and while nursing. Typically, the treatment lasts 3 days.

Healthcare professionals typically use IV and IM antibiotics for more severe infections or when you cannot take oral medications.

Ampicillin/sulbactam (Unasyn) treats infections resistant to certain antibiotics.

Ceftriaxone (Rocephin) is an IV option for uncomplicated UTIs and may be effective in 3-day courses.

Intravenous meropenem/vaborbactam (Vabomere) is a valuable option for complicated UTIs caused by antibiotic-resistant bacteria in adults.

Cefiderocol (Fetroja) is a last-line option for complicated UTIs. However, it can have gastrointestinal side effects, and people with kidney conditions should use it with caution.

Imipenem/cilastatin/relebactam (Recarbrio) is an IV antibiotic that’s typically well tolerated. It’s often used to treat gram-negative infections in adults, including people who are critically ill or at high risk.

Over-the-counter medications may help ease UTI symptoms. For example:

• Acetaminophen may help to reduce pain and fever.
• Phenazopyridine (Pyridium, AZO) helps to alleviate pain and burning.
• Methenamine/Sodium salicylate/Benzoic acid (Cystex) may help to ease pain and inflammation.

These medications do not treat the infection.

While UTIs can resolve without treatment, antibiotics are the standard course of care. A healthcare professional can offer guidance on the best medication, correct dosage, and duration of treatment.

Take the entire course of your antibiotics, even if you start feeling better soon after you first start the medication. This helps ensure your infection fully resolves and reduces the chance of recurrence.

Consult a healthcare professional if your symptoms persist beyond a few days of antibiotic use or worsen.