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.
The number of days your doctor will have you take antibiotics depends on your infection and the type of antibiotic medicine.
Antibiotics for recurrent infections
Doctors sometimes advise that women with repeat infections use 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 right for you.
Medication Choices
Medicines used to treat UTIs include:
- Antibiotics to cure the infection. Antibiotics used for UTIs include sulfonamides with trimethoprim (such as Bactrim), nitrofurantoin (such as Macrobid), and fluoroquinolones (such as Cipro).
- Phenazopyridine (such as Pyridium and Uristat) to treat the pain and burning of a UTI. Uristat is an example of phenazopyridine you can buy without a prescription.
- Other nonprescription medicines for pain. These include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve).
Medicines used to prevent recurrent UTIs include:
- Antibiotics, including sulfonamides with trimethoprim (such as Bactrim).
- Methenamine (such as Hiprex).
- Vaginal estrogen (such as Estring, Vagifem, or Premarin) for women who have been through menopause.
Be sure to tell your doctor if you are or think you may be pregnant. Some of these medicines are not safe to use if you are pregnant.
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. And 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 harder 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 medicine that will kill the bacteria that is 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. 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 start to have 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: | Monica Rhodes | Last Updated: June 8, 2009 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Avery L. Seifert, MD - Urology | |
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