What Are the Best Antibiotics for A UTI?

A urinary tract infection (UTI) is an often-painful condition where bacteria enters the urethra and infects the urinary tract. The bladder is the most common location for the infection to brew, but in severe cases, it can travel to the kidneys, leading to more serious complications.

For those with UTIs, treatment is often desired to relieve the symptoms, although it also helps to prevent a more serious kidney infection. To treat the infection, antibiotics are preferred.

How Do Antibiotics Treat A UTI?

While bacterial UTIs are the most common, it is possible for a UTI to be caused by a fungus or, in rare cases, a virus. However, antibiotics are only effective against bacterial UTIs.

Antibiotics work by getting rid of the bacteria causing the UTI. They can do this through two main mechanisms: directly killing the bacteria or stopping the bacteria from growing/reproducing.

What Are the Best Antibiotics for A UTI?

Not all antibiotics are able to treat a UTI. There are hundreds of antibiotics, and each one treats a particular type of bacteria. Some antibiotics can treat a range of bacteria, which is why they are more popular, but no antibiotic can treat all bacterial infections.

To successfully treat your UTI, you will need an antibiotic that can treat the bacteria causing it, which in most cases is E. coli.

When it comes to treating a UTI, the following antibiotics work the best in adults.

Nitrofurantoin (Macrodantin, Macrobid)

This antibiotic is primarily used for treating UTIs because it is only effective in urine. It works by preventing the bacteria from making the DNA and proteins that help them survive.

Trimethoprim/Sulfamethoxazole (Septra, Bactrim)

This is a combination drug, which means it contains two antibiotics (TMP/SMX) that work together. When these antibiotics are used together, they block two important steps that certain bacteria do to make the proteins that allow them to survive.

In general, TMP/SMX is an excellent treatment for UTIs. However, antibiotic resistance can cause the bacteria to be less sensitive to the antibiotics. In some cases, that can mean that Bactrim may not be as strong as it needs to be against the infection.

Fosfomycin (Monurol)

Fosfomycin is an effective treatment for bacteria that are very resistant to common antibiotics. Its mechanism of action involves killing the UTI-causing bacteria while also preventing the bacteria from sticking to the lining of the urinary tract.

What Is the Best Antibiotic for Urinary Tract Infection?

The three antibiotics listed above are typically first-line treatments for UTIs. Your doctor will choose the best one for you based on your history, type of UTI, and local resistance patterns.

For example, if you have a history of antibiotic resistance, the best antibiotic for you will likely be Fosfomycin since it is recommended for bacteria that are resistant to common antibiotics.

While the above antibiotics typically work best for UTIs, if they are unable to clear the infection, your doctor may then prescribe amoxicillin/potassium clavulanate (Augmentin), cephalexin (Keflex), or cefdinir (Omnicef). All of these antibiotics work by destroying the bacteria’s cell wall.

However, amoxicillin/clavulanate is a type of penicillin, and as such, will not be prescribed for those with a penicillin allergy. Those with penicillin allergies may also experience a reaction to cephalexin or cefdinir, and should discuss these medications with their doctor before taking them. 

What Can Be the Side Effects of UTI Antibiotics?

While side effects can vary based on the antibiotic, stomach upset is a common side effect of most antibiotics, causing diarrhea, nausea, or vomiting. Some antibiotics may also cause fatigue.

It is also possible to be allergic to antibiotics, which may cause a rash or difficulty breathing. It is crucial to seek immediate medical attention if you develop any signs of an allergic reaction after taking an antibiotic.

Fluoroquinolones, such as levofloxacin (Levaquin) and ciprofloxacin (Cipro), are often recommended only for severe infections as they have a higher risk of serious side effects. An FDA safety review found both oral and injectable fluoroquinolones to be associated with serious side effects that impact and potentially disable muscles, tendons, nerves, joints, and the central nervous system.

Are There Any Alternative UTI Medicines?

While antibiotics are the most common treatment for UTIs in children and adults, there are some alternative and natural treatment options to help reduce overexposure to antibiotics. Additionally, many of these treatments can be used with antibiotics to increase the medicine’s effectiveness. 

D-Mannose

D-mannose is a type of simple sugar that can be taken in a powder or tablet form for UTI treatment. While the exact mechanism of D-mannose is unknown, experts suspect that it inhibits certain bacteria from adhering to the cells in your urinary tract, making it easier for the bacteria to be flushed out when urinating.

Cranberry Extract

Cranberry products are commonly associated with UTIs and are a popular choice for treatment. Cranberries contain chemical compounds such as D-mannose, anthocyanins, and hippuric acid, which can help prevent bacteria from adhering to the urinary tract.

Of the different cranberry products, cranberry extract contains the chemical compounds at a higher concentration than cranberry juice, making it a more effective treatment and preventive measure, 

However, while research suggests that cranberry extract may relieve UTI symptoms, it is not as effective as D-mannose and is more effective as a preventative measure than a treatment.

Green Tea

Green tea contains the compound epigallocatechin (EGC), which shows potent antibacterial effects against E. coli, one of the most common bacterial causes of UTIs.

Additionally, studies have found that the EGC in green tea may make the antibiotics used to treat UTIs more effective.

Uva Ursi

Uva Ursi, also known as bearberry lead, has been used to treat UTIs for centuries.

The primary compound in uva ursi that supports UTI treatment is arbutin, and this is because it has an antibacterial effect on E. coli.

Research surrounding the benefits of uva ursi for UTIs is mixed, though, with some studies finding a significant reduction in UTI recurrence, whereas others find no noticeable benefit.

When To See a Doctor?

Because UTIs can become kidney infections, it is best to see your doctor as soon as you suspect you have a UTI.

It is recommended to see a doctor, even if you are interested in alternative and herbal medications for UTIs. Your doctor can discuss the options and help you create a safe and effective treatment plan. UTIs can quickly lead to serious health conditions, so it is not recommended to try and treat a UTI on your own.

Additionally, if you have any of the following symptoms, you may have a kidney infection and should seek immediate medical attention:

  • fever
  • chills
  • pain in the lower back
  • blood in your urine

Get Help from An Online Doctor

For those with a UTI, an online doctor is an excellent way to receive an antibiotic prescription without having to leave your house. With DrHouse, you can meet with a doctor in just 15 minutes to discuss your symptoms and receive a prescription.

Key Takeaways

Urinary tract infections are unpleasant conditions that most often result from a bacterial infection of the urinary tract. When the UTI is from bacteria, antibiotics can be used to treat the infection and relieve your symptoms.

The antibiotics most often used to treat UTIs include nitrofurantoin, trimethoprim/sulfamethoxazole, and fosfomycin. However, the best antibiotic for your infection will depend on the infection severity, history, and resistance patterns.

There are some common side effects of antibiotics, with stomach upset the most prevalent. However, this should clear up within a day. There are also alternative medicines for UTIs, including D-mannose, cranberry extract, and green tea. However, these treatments typically work best in conjunction with antibiotics to increase antibiotic effectiveness.

Sources

  • FDA updates warnings for oral and injectable fluoroquinolone. (2019). Retrieved 23 August 2022, from https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-updates-warnings-oral-and-injectable-fluoroquinolone-antibiotics 
  • Domenici, L., Monti, M., Bracchi, C., Giorgini, M., Colagiovanni, V., Muzii, L., & Benedetti Panici, P. (2016). D-mannose: a promising support for acute urinary tract infections in women. A pilot study. European review for medical and pharmacological sciences, 20(13), 2920–2925.
  • Nalliah, S., Fong, J., Yi Thor, A. Y., & Lim, O. H. (2019). The use of chemotherapeutic agents as prophylaxis for recurrent urinary tract infection in healthy nonpregnant women: A network meta-analysis. Indian journal of urology : IJU : journal of the Urological Society of India, 35(2), 147–155. https://doi.org/10.4103/iju.IJU_378_18 
  • Reygaert, W., & Jusufi, I. (2013). Green tea as an effective antimicrobial for urinary tract infections caused by Escherichia coli. Frontiers In Microbiology, 4. doi: https://www.doi.org/10.3389/fmicb.2013.00162 
  • Noormandi, A., & Dabaghzadeh, F. (2015). Effects of green tea on Escherichia coli as a uropathogen. Journal Of Traditional And Complementary Medicine, 5(1), 15-20. doi: https://www.doi.org/10.1016/j.jtcme.2014.10.005 
  • Gohari, A. R., & Saeidnia, S. (2014). The role of herbal medicines in treatment of urinary tract diseases. Journal of nephropharmacology, 3(1), 13–14.
  • Larsson, B., Jonasson, A., & Fianu, S. (1993). Prophylactic effect of UVA-E in women with recurrent cystitis: A preliminary report. Current Therapeutic Research, 53(4), 441-443. doi: https://www.doi.org/10.1016/s0011-393x(05)80204-8 
  • Moore, M., Trill, J., Simpson, C., Webley, F., Radford, M., & Stanton, L. et al. (2019). Uva-ursi extract and ibuprofen as alternative treatments for uncomplicated urinary tract infection in women (ATAFUTI): a factorial randomized trial. Clinical Microbiology And Infection, 25(8), 973-980. doi: https://www.doi.org/10.1016/j.cmi.2019.01.011 

DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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