Urinary Tract Infection Medications

A urinary tract infection (UTI) is an infection in your urinary tract. Bladder infections are also called cystitis and are usually considered a “simple UTI”. Treatment is usually with antibiotics (such as nitrofurantoin) for three to seven days. Some bacteria are resistant to antibiotics commonly used for UTIs and preferred treatment depends on the local antibiotic treatment protocol, duration of infection, and other conditions (such as pregnancy). Examples include:

• Nitrofurantoin: Avoid in late pregnancy (after 36 weeks gestation), and if creatinine clearance is less than 60 mL/min
• Sulfonamides (sulfa drugs), such as sulfamethoxazole/trimethoprim although not recommended in the first trimester of pregnancy
• Fosfomycin
• Amoxicillin
• Amoxicillin-clavulanate potassium
• Doxycycline
• Cephalosporins, such as cephalexin
• Quinolones, such as ciprofloxacin, norfloxacin, or levofloxacin (usually last resort due to resistance and the rare risk of severe side effects).

Paracetamol or ibuprofen can be used for pain relief if necessary.

Concomitant urinary alkalinisers are no longer routinely recommended in the acute treatment of urinary tract infections as they raise urinary pH which may decrease the effectiveness of some antibiotics (e.g. nitrofurantoin).

For a urinary tract infection (UTI), seeing a healthcare provider is essential for antibiotics. Follow the full antibiotic course even if symptoms improve. For frequent UTIs, antibiotics may be recommended daily, every other day, post-sex, or at symptoms' onset.

Some minor urinary tract infections may resolve without treatment, but antibiotics are typically required for most UTIs. Antibiotics are essential, especially if you experience symptoms like fever, chills, nausea, and vomiting alongside a UTI.

What are the Symptoms of a UTI

Symptoms of a UTI can differ depending on what part of the urinary tract is infected.

A bladder infection usually causes symptoms that include the following:

• Burning when urinating (the medical term for this is dysuria)
• The feeling that you need to pee frequently, but when you go to the toilet very little urine comes out
• Pain in the pelvic area just above the pubic bone.

People with an infection of the urethra (called urethritis) may experience symptoms similar to a bladder infection in addition to itching or irritation at the end of the urethra where the pee comes out.

Symptoms of a kidney infection are usually more widespread and more severe than those of a bladder infection and may include:

• Fever or chills
• Cloudy or foul-smelling urine
• Pink or red-tinged urine (this is a sign of bleeding in the urinary tract)
• Burning when urinating
• The feeling that you need to pee frequently, but when you go to the toilet very little urine comes out
• Pain in the pelvic area just above the pubic bone
• Moderate to severe lower back pain
• Nausea or vomiting.

Kidney infections are considered the worst type of UTI and usually start as a bladder or urethra infection but then the bacteria multiply and travel up to the kidneys. Kidney infections are usually called complicated UTIs and some people may require hospitalization for intravenous antibiotics. Less severe infections may be treated with oral antibiotics over a week or more. Untreated kidney infections can be life-threatening.

Preventing UTIs

There is controversy over whether unsweetened cranberry juice is an effective treatment or prevention for UTIs. A 2013 review of 24 studies concluded that it was less effective than previously thought. The risk of UTIs may be lessened by staying hydrated and urinating when the need arises, not holding it in.

Women should wipe from front to back after a bowel movement, urinate before and after sex, and avoid using douches, vaginal sprays, and scented feminine hygiene products. They should avoid wearing restrictive, synthetic clothing, or change out of such clothing as soon as possible after exercising or swimming.

What Causes UTIs

Most UTIs are caused by bacteria, such as Escherichia coli, Klebsiella pneumoniae, or Staphylococcus saprophyticus.

Your urinary tract includes your bladder, kidneys, ureter (the tube that connects your kidneys to your bladder), and urethra (the tube that removes urine from your body). A bladder infection is a type of urinary tract infection, but not all UTIs are bladder infections.

What Increases Your Risk for UTIs?

Women of all ages are most at risk of UTIs because the female urethra is much shorter than the male urethra, which allows bacteria near the vagina to enter the bladder more easily. Older males are also at a higher risk. Other factors that increase the risk of a UTI include:

• Sexual intercourse
• Certain contraceptives (eg, diaphragms or spermicides)
• Wiping from back to front after a bowel movement
• The presence of kidney or bladder stones
• Urinating without fully emptying the bladder
• Pregnancy
• Having a urinary catheter.

UTIs in children are reasonably common, affecting up to 8% of girls and 2% of boys. Young children also have a higher risk of kidney damage from UTIs than adults.  Some children are born with vesicoureteral reflux, where urine reenters the bladder from one or both ureters, which also increases the likelihood of UTIs.

A bladder infection is a type of urinary tract infection, but not all UTIs are bladder infections. Bladder infections are the most common type of UTIs. A bladder infection may also be called cystitis and it is usually caused by bacteria.