Antibiotics commonly used to treat urinary tract infections (UTIs) include:
- Nitrofurantoin (Macrobid, Macrodantin): Often used for uncomplicated UTIs; it slows bacterial growth to help the immune system clear the infection
- Trimethoprim-sulfamethoxazole (Bactrim, Septra): A combination antibiotic frequently prescribed for UTIs; however, resistance is increasing and it is not recommended during pregnancy or nursing
- Fosfomycin (Monurol): A single-dose antibiotic effective for uncomplicated UTIs caused by common bacteria like E. coli
- Cephalexin (Keflex) and other first-generation cephalosporins: Used especially for those allergic to penicillin; generally safe during pregnancy
- Doxycycline : Sometimes used, depending on the bacteria identified
- Ceftriaxone : Often given intravenously for complicated or severe infections
- Fluoroquinolones (e.g., ciprofloxacin, levofloxacin): Reserved for complicated UTIs due to concerns about resistance and side effects; not recommended for children or during pregnancy
For complicated UTIs or kidney infections, intravenous antibiotics such as ertapenem, piperacillin-tazobactam, or combinations like meropenem plus vancomycin may be used
. Newer antibiotics approved recently include:
- Pivmecillinam (Pivya) for uncomplicated UTIs in adult women
- Orlynvah (sulopenem etzadroxil and probenecid) for uncomplicated UTIs targeting resistant bacteria
The choice of antibiotic depends on whether the UTI is uncomplicated or complicated, local bacterial resistance patterns, patient history, and safety considerations such as pregnancy
. In summary, first-line oral antibiotics for uncomplicated UTIs typically are nitrofurantoin, trimethoprim-sulfamethoxazole, and fosfomycin, while more severe or complicated infections may require intravenous therapy with broader- spectrum antibiotics
