Table of ContentsView AllTable of ContentsAntibiotics Used for UTIsHow Do Antibiotics Work?Side EffectsHow Long Does Treatment Last?Are There OTC Remedies for UTIs?
Table of ContentsView All
View All
Table of Contents
Antibiotics Used for UTIs
How Do Antibiotics Work?
Side Effects
How Long Does Treatment Last?
Are There OTC Remedies for UTIs?
Urinary tract infections (UTIs)are bacterial infections of the urinary tract. The most common type of UTI iscystitiswhich occurs in the lower portion of the urinary tract when bacteria enter the urethra and travel to the bladder.
As the bacteria multiply in the urinary tract, they causesymptomssuch as pain with urination, feeling like you need to urinate more frequently, feeling the need to urinate even if you’ve just emptied your bladder, and blood in the urine.
If you are diagnosed with a UTI, your healthcare provider will prescribeantibiotics. Antibiotics commonly recommended to treat UTIs are Macrobid (nitrofurantoin), Bactrim (trimethoprim/sulfamethoxazole), and Monurol (fosfomycin).
Fluoroquinolones like ciprofloxacin are no longer routinely recommended due to their side effects and increasing bacterial resistance.
This article will discuss the most common antibiotics used to treat UTIs, how they work, their side effects, and more.
Jacob Wackerhausen / Getty Images
Commonly Used Antibiotics for Urinary Tract Infections
Nitrofurantoin
Nitrofurantoin is effective against most bacteria that commonly cause UTIs. There is minimal bacterial resistance to nitrofurantoin, making it a good first-line option.
If prescribed nitrofurantoin, you will typically take it for five days.
Trimethoprim/Sulfamethoxazole
Trimethoprim/sulfamethoxazole is a combination medication containing two antibiotics.
Although it can be an effective treatment for UTIs, in recent years, bacterial resistance has increased. Therefore, this drug is usually only used in areas where the resistance rate is less than 20%.
Fosfomycin
Fosfomycin is another suitable antibiotic option for UTIs due to minimal bacterial resistance. However, it appears to be less effective than other standard short-course treatments.
The treatment course is just a single dose, making it a convenient option. It comes as a powder that needs to be mixed with a half-cup (3 to 4 ounces) of cool water before drinking. You do not need to take it with food.
Fluoroquinolones
Fluoroquinolones are a class of antibiotics that include ciprofloxacin, ofloxacin, and levofloxacin.
These medications should be used only if other options are not suitable. Increasing bacterial resistance to fluoroquinolones has made this class of antibiotics less useful for UTI treatment in recent years.
Complicated vs. Uncomplicated UTIs
A UTI is classified asuncomplicatedwhen it occurs in people who are premenopausal, nonpregnant, and without urological abnormalities or co-existing health conditions.The antibiotics covered in this article apply to treating uncomplicated UTIs.
How Do Antibiotics Treat UTIs?
Side Effects of Antibiotics
Like most antibiotics, the ones prescribed for UTIs have the potential to cause side effects.
Nausea and stomach upset are common ones that can occur with any of the three antibiotics commonly used for UTIs.
Other common side effects include the following:
Trimethoprim/sulfamethoxazole
Most side effects are mild and temporary while taking antibiotics. If you experience side effects that are severe enough to consider stopping treatment, contact a healthcare provider to see if an alternative antibiotic needs to be substituted to complete therapy.
How Effective Is Doxycycline for a UTI?
How Long Do Antibiotics Take to Treat a UTI?
Symptoms of a UTI improve rapidly after starting antibiotics, usually within a few hours. Do not stop taking antibiotics once you start to feel better, and do not save antibiotics to use later.
It can take several days to clear the infection fully, so it is important to finish the entire course of antibiotics prescribed (usually three to five days).
Contact your healthcare provider for reevaluation if you notice no improvement in symptoms after starting antibiotics or if symptoms worsen.
Preventing Antibiotic Resistance
Even though you feel better, it’s important to keep taking the antibiotics until you finish the entire course. It takes time to kill all of the bacteria causing infection. Stopping antibiotics too early could cause the infection to return and lead to bacteria developing antibiotic resistance.
Resistance occurs when bacteria are exposed to an antibiotic but not completely killed. The remaining bacteria can develop a mutation that helps them survive, leading to bacteria that are harder to treat in the future.
Are There Over-the-Counter Remedies for UTIs?
There are no over-the-counter (OTC) treatments to cure a UTI, though some OTC products can help temporarily relieve the symptoms.
AZO (phenazopyridine) is a bladder anesthetic that temporarily relieves symptoms of burning, pain, urgency, and frequency but does not treat the bacterial infection.
You should always see a healthcare provider if you suspect a UTI. An untreated infection can progress up the urinary tract to evolve into a more severe infection of the kidneys (pyelonephritis).
Summary
UTIs are a common bacterial infection that requires treatment with antibiotics. The most commonly prescribed antibiotics for UTIs are nitrofurantoin, trimethoprim-sulfamethoxazole, and fosfomycin.
Your healthcare provider will select an appropriate antibiotic based on what they know about the most common bacteria in your local area.
Most antibiotic regimens for UTIs are one to five days in length. It is important to finish all of the prescribed antibiotics and return to see a healthcare provider if your symptoms do not improve after starting treatment.
Frequently Asked QuestionsWhen treating a UTI, healthcare providers select an antibiotic empirically. Empiric treatment is a best guess that accounts for the types of bacteria that commonly cause the infection and information about local antibiotic resistance patterns. They will also consider patient-specific data such as drug allergies. Sometimes collecting a urine sample for culture is part of the evaluation process, and the results of a urine culture will tell a healthcare provider if a change in antibiotic is needed. Because culture results take one to two days, they are not helpful for initial antibiotic selection.The best antibiotic for an infection treats the infecting bacteria while minimally affecting the balance of healthy bacteria in the body. All of the most commonly used antibiotics kill bacteria in the urine.Yes, though the choice of antibiotic may differ for non-pregnant people.Yes, antibiotics are needed to clear a bacterial infection. However, there are non-infectious causes of cystitis (e.g., chemical, foreign body) symptoms, so if your symptoms do not improve after taking antibiotics, see a healthcare provider for further evaluation.If your symptoms return after finishing antibiotics, return to see a healthcare provider for evaluation. A urine culture will be an important part of determining whether you have an ongoing infection, need a different antibiotic, or if there is another medical problem causing your symptoms.
Frequently Asked Questions
When treating a UTI, healthcare providers select an antibiotic empirically. Empiric treatment is a best guess that accounts for the types of bacteria that commonly cause the infection and information about local antibiotic resistance patterns. They will also consider patient-specific data such as drug allergies. Sometimes collecting a urine sample for culture is part of the evaluation process, and the results of a urine culture will tell a healthcare provider if a change in antibiotic is needed. Because culture results take one to two days, they are not helpful for initial antibiotic selection.
The best antibiotic for an infection treats the infecting bacteria while minimally affecting the balance of healthy bacteria in the body. All of the most commonly used antibiotics kill bacteria in the urine.
Yes, though the choice of antibiotic may differ for non-pregnant people.
Yes, antibiotics are needed to clear a bacterial infection. However, there are non-infectious causes of cystitis (e.g., chemical, foreign body) symptoms, so if your symptoms do not improve after taking antibiotics, see a healthcare provider for further evaluation.
If your symptoms return after finishing antibiotics, return to see a healthcare provider for evaluation. A urine culture will be an important part of determining whether you have an ongoing infection, need a different antibiotic, or if there is another medical problem causing your symptoms.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Urinary tract infection.Langner JL, Chiang KF, Stafford RS.Current prescribing practices and guideline concordance for the treatment of uncomplicated urinary tract infections in women.Am J Obstet Gynecol. 2021;225(3):272.e1-272.e11. doi:10.1016/j.ajog.2021.04.218DailyMed.Label: MONUROL- fosfomycin tromethamine powder.DailyMed.Label: MACROBID- nitrofurantoin monohydrate/macrocrystalline capsule.DailyMed.Label: BACTRIM DS- sulfamethoxazole and trimethoprim tablet, BACTRIM DS- sulfamethoxazole and trimethoprim tablet.Centers for Disease Control and Prevention.About antimicrobial resistance.DailyMed.Label: AZO URINARY PAIN RELIEF MAXIMUM STRENGTH- phenazopyridine hydrochloride tablet.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Urinary tract infection.Langner JL, Chiang KF, Stafford RS.Current prescribing practices and guideline concordance for the treatment of uncomplicated urinary tract infections in women.Am J Obstet Gynecol. 2021;225(3):272.e1-272.e11. doi:10.1016/j.ajog.2021.04.218DailyMed.Label: MONUROL- fosfomycin tromethamine powder.DailyMed.Label: MACROBID- nitrofurantoin monohydrate/macrocrystalline capsule.DailyMed.Label: BACTRIM DS- sulfamethoxazole and trimethoprim tablet, BACTRIM DS- sulfamethoxazole and trimethoprim tablet.Centers for Disease Control and Prevention.About antimicrobial resistance.DailyMed.Label: AZO URINARY PAIN RELIEF MAXIMUM STRENGTH- phenazopyridine hydrochloride tablet.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Urinary tract infection.Langner JL, Chiang KF, Stafford RS.Current prescribing practices and guideline concordance for the treatment of uncomplicated urinary tract infections in women.Am J Obstet Gynecol. 2021;225(3):272.e1-272.e11. doi:10.1016/j.ajog.2021.04.218DailyMed.Label: MONUROL- fosfomycin tromethamine powder.DailyMed.Label: MACROBID- nitrofurantoin monohydrate/macrocrystalline capsule.DailyMed.Label: BACTRIM DS- sulfamethoxazole and trimethoprim tablet, BACTRIM DS- sulfamethoxazole and trimethoprim tablet.Centers for Disease Control and Prevention.About antimicrobial resistance.DailyMed.Label: AZO URINARY PAIN RELIEF MAXIMUM STRENGTH- phenazopyridine hydrochloride tablet.
Centers for Disease Control and Prevention.Urinary tract infection.
Langner JL, Chiang KF, Stafford RS.Current prescribing practices and guideline concordance for the treatment of uncomplicated urinary tract infections in women.Am J Obstet Gynecol. 2021;225(3):272.e1-272.e11. doi:10.1016/j.ajog.2021.04.218
DailyMed.Label: MONUROL- fosfomycin tromethamine powder.
DailyMed.Label: MACROBID- nitrofurantoin monohydrate/macrocrystalline capsule.
DailyMed.Label: BACTRIM DS- sulfamethoxazole and trimethoprim tablet, BACTRIM DS- sulfamethoxazole and trimethoprim tablet.
Centers for Disease Control and Prevention.About antimicrobial resistance.
DailyMed.Label: AZO URINARY PAIN RELIEF MAXIMUM STRENGTH- phenazopyridine hydrochloride tablet.
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