Urinary Tract Infections in Teens and Adults
Medications
Oral antibiotics can treat most bladder infections and uncomplicated kidney infections successfully. In many cases, if the symptoms and urinalysis suggest a urinary tract infection (UTI), you will start taking antibiotics without waiting for the results of a urine culture.
How long you will need to take antibiotics depends on the location of the infection, your age, your gender, and any complicating medical conditions.
- Women with uncomplicated bladder infections (cystitis) usually take antibiotics for 3 days. In the past, longer courses of treatment were common, but studies show that the shorter course of antibiotics is just as effective and causes fewer side effects.4
- Women with bladder infections who have had a recent UTI or who have symptoms for more than 7 days may require a 7-day course of antibiotics.
- Men with bladder infections usually take antibiotics for 7 to 14 days. If the prostate is infected as well, treatment may last 4 weeks or more.
- Men and women with kidney infections (pyelonephritis) may take antibiotics for 10 to 14 days. In severe cases, treatment may require intravenous (IV) antibiotics and fluids in a hospital.
- Men and women who are older than 65, have diabetes or an impaired immune system, or have other urinary problems usually require longer courses of antibiotics.
- People who have infections that do not respond to treatment or are complicated by other factors may require longer antibiotic therapy.
Antibiotics for recurrent infections
Doctors sometimes advise that women with repeat infections take antibiotics for 2 to 6 weeks, followed by preventive antibiotic therapy. This may include taking a small dose of antibiotics daily or on alternate days, taking antibiotics after sexual intercourse (since sex often triggers UTIs in women with recurrent infections), or taking antibiotics only when you develop symptoms. Talk with your doctor about which treatment strategy is appropriate for you.
Medication Choices
Antibiotic medications that treat UTIs include:
- Sulfonamides with trimethoprim (such as Bactrim or Septra).
- Trimethoprim (Proloprim).
- Fluoroquinolones (such as Cipro or Floxin).
- Cephalosporins (such as Keflex or Duricef).
- Nitrofurantoin (such as Macrobid or Macrodantin).
- Penicillins (such as ampicillin or amoxicillin).
- Tetracycline (such as Declomycin or Vibramycin).
Phenazopyridine treats the pain and burning that often accompany a UTI.
Be sure to tell your doctor if you are or think you may be pregnant. Some of these medications are not safe to use during pregnancy.
What To Think About
These medicines are often prescribed in a less costly generic form, rather than under a brand name. A pharmacist might also decide to give you a generic instead of a brand name medicine unless the prescription says "no generic."
Take all of the antibiotics your doctor has prescribed. Most people begin to feel better soon after they begin the medicine. But if you stop taking the medicine as soon as you feel better, the infection may return. More importantly, not taking the full course of antibiotics encourages the development of bacteria that are resistant to antibiotics. This not only makes antibiotics less effective but also makes bacterial infections more difficult to treat.
Many forms of bacteria have become resistant to common antibiotics designed to destroy them. These are called antibiotic-resistant bacteria. Antibiotic resistance among bacteria that cause UTIs has increased steadily in recent decades. You and your doctor may have to try different antibiotics, and different combinations of antibiotics, to find the right medication that will kill the bacteria causing your UTI. Before starting you on a new antibiotic, your doctor may get a urine sample from you. Results from tests on this sample will help guide the decision on which antibiotic you take next.
If your doctor prescribes antibiotics, ask whether there are any potential drug interactions you should be aware of. For instance, some antibiotics used to treat UTIs may make birth control pills less effective. Your doctor may recommend a backup form of birth control. Antibiotics can also reduce the effectiveness of warfarin (Coumadin), an anticoagulant (blood thinner) that lowers the risk of heart attack and stroke in people at high risk for these conditions.
Antibiotics for recurrent UTIs
For women who have recurrent UTIs, some doctors may write a standing prescription for antibiotics that a woman can take as soon as she has symptoms of a UTI. This saves the cost and inconvenience of a clinic visit. It also allows a woman familiar with the typical symptoms of a UTI to begin treating the infection without delay.5 Talk with your doctor about whether this self-treatment strategy is right for you. If you and your doctor have agreed to follow this approach and you develop symptoms that you are certain are caused by a UTI, follow your doctor's instructions for taking the medicine and for monitoring your symptoms.
Be sure to notify your doctor if your symptoms do not improve or if you start having UTIs more often than in the past.
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| Author: | Kathe Gallagher, MSW | Last Updated: June 15, 2007 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Philip Belitsky, MD, FRCSC - Urology | |
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