The urinary tract is comprised of the ureters (tubes that transport urine from the kidneys to the bladder), kidneys, bladder, and urethra (tube running from the bladder to the outside of the body). Urinary
tract infections wake forest nc (UTIs) are most commonly located in the urethra and bladder and while typically caused by bacteria, UTIs can also be viral or fungal. For patients suffering from a bacterial UTI, they may be curious about what antibiotics are the best for treating their infection. Based on a study by The National Center for Biotechnology Information, the bacteria most commonly associated with causing UTIs are: Based on the symptoms the patient is experiencing and before any testing is done to officially determine the infection type, the doctor prescribes first line antibiotics. For most UTIs, the prescribed antibiotic will cure the infection and not require any further testing. Notably absent from the list of antibiotics prescribed for the treatment of UTIs is Amoxicillin. While very popular and useful in treating numerous other bacterial infections, urinary tract infections
are not amongst the infections Amoxicillin is used for. Once an antibiotic treatment regimen is started, patients can expect to feel relief from their UTI symptoms in as little as one or two days. The severity of the infection will ultimately determine how long the doctor prescribes the antibiotic. Mild UTIs that are uncomplicated, could be treated by antibiotics in as few as three days. However, some doctors may require the
antibiotics be taken for a week to ensure the infection is fully cleared and if the UTI is complicated, antibiotic treatments could last for up to two weeks. Despite feeling better and having symptoms improve after initially starting antibiotic treatments, patients need to realize that they are not fully recovered and that some bacteria could remain in their urinary tract. If antibiotics are discontinued too early, any remaining bacteria are given the opportunity to reproduce.
Since these bacteria were exposed to antibiotics, there is a possibility that the reproduced bacteria will be resistant to antibiotics and lead to a significantly worse infection that is more difficult to treat. As such, taking the antibiotic for the entire duration of the prescription time is vitally important to ensuring the bacteria is fully removed. Should a patient take the prescribed antibiotics for several days without seeing improvement to their UTI, there are two
possibilities. First, the infection may not be bacterial. Second, the antibiotic may not be effective in fighting off the particular bacteria causing the UTI. In either situation, additional urine testing will be done to check for different viruses, fungi, and bacteria that could be causing the UTI in order to formulate a different treatment plan. Lab results are typically back in 2-3 days at which point the doctor can prescribe a new treatment plan. Like any medication, antibiotics do have the potential to cause side effects. The most common side effects related to the use of antibiotics are: More on Urinary Tract Infections : Diagnosing and Treating a Urinary Tract
Infection When it comes to treating urinary tract infections (UTIs), antibiotics continue to be the number one go-to treatment. Most often, these drugs come in the form of pills that are taken orally, often over a period of several days. (1) Antibiotics Used for Uncomplicated UTIsIf you are a healthy individual whose urinary tract is anatomically and functionally normal — and you have no known heightened UTI susceptibility — you’ve got what’s dubbed an uncomplicated UTI, according to guidelines published in August 2019 in the Journal of Urology. (2) For these individuals, antibiotics are considered the first-line of treatment. The type of antibiotics you are prescribed — and for how long — is contingent on the type of bacteria detected in your urine, your current health status, and whether your UTI is uncomplicated or complicated. (More on complicated UTIs later.) Depending on which antibiotic your doctor prescribes, women may need a single dose or up to a five-day course. For men, antibiotics are usually given for a slightly longer period of time, notes UpToDate. (3) Typically, if you are diagnosed with an uncomplicated UTI, one of the following will be prescribed as first-line treatment:
The following antibiotics are considered second-line treatments for UTI. They are generally chosen because of resistance patterns or allergy considerations: (2)
In most cases, either a three-day or five-day course of a UTI antibiotic is prescribed to treat an uncomplicated UTI. Usually pain and the frequent urge to urinate subsides after a few doses. Regardless of the medication prescribed or how quickly you feel relief, it’s always important to complete the entire course of antibiotics as directed by your healthcare provider. If UTIs are not fully treated, they can more easily return, notes the Urology Care Foundation. (8) RELATED: The Connection Between E. Coli and UTIs Antibiotics Used for Complicated UTIsBefore getting into how to best treat a complicated UTI, it’s important to understand which UTIs are considered complicated. Here are some guidelines:
Kidney infections are often treated as a complicated UTI as well, notes the Merck Manual. (9) If a UTI is complicated, a different course of antibiotics may be required. And the initial dose of antibiotics may be started intravenously (IV) in the hospital. After that, antibiotics are given orally at home. In addition, follow-up urine cultures are generally recommended within 10 to 14 days after treatment. Not all of the antibiotics approved for uncomplicated UTIs are appropriate for the complicated version. Some that are considered appropriate, include:
Antibiotic Warnings and Treatment ConcernsThe most commonly prescribed antibiotics for uncomplicated UTIs are similar in efficacy. But it’s important to note that ampicillin, amoxicillin, and sulfonamides are no longer the drugs of choice for combatting UTIs because of the emergence of antibiotic resistance. In addition, amoxicillin and clavulanate (Augmentin) has been shown in previous research to be significantly less effective than others when it comes to treating urinary tract infections. (13) Also, as noted above, the FDA advises against using fluoroquinolones (including Cipro and Levaquin) for uncomplicated UTIs. These medicines should only be considered if no other treatment options are available. In some cases, such as a complicated UTI or kidney infection, a healthcare provider may decide that a fluoroquinolone medicine is the best option, notes the American Academy of Family Physicians. (14) For pregnant women, some common antibiotics, such as fluoroquinolones and tetracyclines, should not be prescribed because of possible toxic effects on the fetus. But oral nitrofurantoin and cephalexin (Keflex) are considered good antibiotic choices for pregnant women with asymptomatic bacteriuria (a UTI without symptoms) and acute cystitis, according to past research. (15) While most UTIs can be effectively treated with antibiotics, bacteria are becoming more and more resistant to antibiotics. Each time you take an antibiotic, the bacteria that normally resides in your system are more likely to become resistant to antibiotics. Because of this, prevention and a proper diagnosis are very important factors in treating UTIs, notes the Centers for Disease Control and Prevention (CDC). (16) Treatment Strategies for Recurrent UTIsRecurrent urinary tract infections, defined as three or more UTIs within 12 months, or two or more occurrences within six months, is very common among women — these but aren’t treated exactly the same as standalone UTIs. One of the reasons: Continued intermittent courses of antibiotics are associated with allergic reactions, organ toxicities, future infection with resistant organisms, and more. Because of this, it’s strongly recommended that you receive both a urinalysis and urine culture from your healthcare provider prior to initiating treatment. Once the results are in, the American Urological Association suggests that healthcare professionals do the following:
For those whose UTI recurrences are related to intercourse, postcoital prophylaxis may be prescribed. In this case, women take antibiotics after intercourse, according to an article published in April 2016 in American Family Physician Journal. (17) RELATED: The Link Between UTIs and Sex: Causes and How to Prevent Them While managing risk factors, like wiping from front to back, prove to be helpful in preventing standalone UTI, the American Urological Association noted that case-control studies clearly show that changes in hygiene practices — using the bathroom pre- and post-intercourse, avoiding hot tubs, tampons, and douching — do not actually play a role in preventing recurrent UTIs. (2) UTIs Caused by ESBL-Producing Bacteria: What to KnowCurrently, there’s an increased incidence of urinary tract infections due to extended-spectrum beta-lactamase (ESBL)–producing E. coli. Not only are ESBL infections harder to treat, those with this type of infection are at greater risk for a potentially life-threatening infection called sepsis, noted an article published in 2017 in Open Forum Infectious Diseases. (18) Those most at risk, according to article published in November 2019 in Pediatrics International, include individuals with any of the following:
Treating UTIs Caused by ESBL-Producing BacteriaAntibiotics classified as carbapenems (imipenem, meropenem, doripenem, and ertapenem) are often the drug of choice when treating UTIs caused by ESBL-producing bacteria. Antimicrobials, such as nitrofurantoin, fosfomycin, amikacin, and cefepime, may also be an option, per an article published in 2015 in the American Journal of Hospital Medicine. (20) When to Contact Your Physician About SymptomsIf during the course of your treatment, your symptoms remain unchanged or worsen, or new symptoms arise, contact your healthcare provider immediately. It is also imperative to contact your physician if during treatment you develop:
Are There Natural, At-Home Remedies to Help UTIs?Yes. While taking antibiotics is still considered the gold standard of UTI treatments, there are some things you can do at home that help relieve symptoms, as well. These include:
RELATED: 8 Home Remedies for Urinary Tract Infections (UTI) Symptoms What About Cranberry Juice for UTI?It’s a long-held belief that consuming cranberry juice may help prevent and treat urinary tract infections. While it’s true that cranberries contain an active ingredient (proanthocyanidins, or PACs) that can prevent adherence of bacteria to the urinary tract, there is still no evidence that cranberry products can treat a UTI. One of the reasons: Products like cranberry juice or cranberry capsules are not explicitly formulated with the same amount of PACs that have shown potential in lab studies. Moreover, a 2019 report in the Journal of Urology noted that “the availability of such products to the public is a severe limitation to the use of cranberries for [recurrent] UTI prophylaxis outside the research setting.” (2) In all, there’s actually very little high-quality research on the topic of prevention. For instance, a 2016 study in The Journal of the American Medical Association, found that among female nursing home residents, daily consumption of cranberry capsules resulted in no significant prevention of UTIs. (24) While consuming cranberry juice or supplements is not considered a first-line treatment of urinary tract infections, in most cases, it can’t hurt. After all, drinking plenty of liquids does dilute your urine and help spur more frequent urination, which flushes bacteria from the urinary tract. The exception: Those who are taking blood-thinning medication, such as warfarin, should not consume cranberry juice. And those with diabetes should be mindful of the high-sugar content of fruit juices. What Over-the-Counter Treatment Options Are Safe To Use?In addition to antibiotics, your doctor may recommend phenazopyridine (Azo Urinary Pain Relief, Pyridium). This is an over-the-counter (OTC) medication used to numb the lining of the urinary tract to make urination more comfortable while you wait for the antibiotics to work. (Be aware that the medicine will make your urine turn bright orange.) Another popular OTC UTI product is Cystex, a combo of methenamine, sodium salicylate, and benzoic acid, also meant to ease pain. It’s very important to note that these products are only meant to relieve pain associated with UTIs. They are in no way meant to replace the use of antibiotics. If you read closely on the AZO website, for instance, you’ll find that the company clearly states “the only clinically proven cure for a UTI is a prescription antibiotic.” Plus, taking this phenazopyridine-based UTI meds may actually interfere with your urine test results. (25) While both products are generally considered safe, if you’re pregnant or breastfeeding with a UTI, consult with your healthcare provider before taking Cystex. And know that these products have not been reviewed by the FDA for efficacy. (26,27) Can a UTI Go Away On Its Own?While most patients with a UTI will be prescribed antibiotics, the truth is, uncomplicated urinary tract infections are often self-limiting, meaning they can potentially run their course sans antibiotic treatment, noted a 2018 report in PLoS Medicine. (28) In fact, that same report (a randomized, controlled, double-blind study) found that more than one-half of the women studied experienced a UTI resolution without the use antibiotics. (The women took ibuprofen instead.) However, since kidney infections (pyelonephritis) occurred in 7 out of 181 women using ibuprofen, the researchers concluded that, at this time, they cannot recommend ibuprofen alone as initial treatment to women with uncomplicated UTIs. A better idea, for now: Simply wait until a positive urine culture comes back before treating with antibiotics. What Happens When a UTI Goes Untreated?Thanks to early diagnosis and proper treatment, the vast majority of lower urinary tract infections result in no complications. However, if left untreated, a UTI can have serious ramifications notes the Mayo Clinic, including:
Editorial Sources and Fact-Checking
What is the first drug of choice for UTI?Trimethoprim-sulfamethoxazole or trimethoprim should be used as first-line therapy because of its low cost and efficacy for uncomplicated urinary tract infections in women unless the prevalence of resistance to these agents among uropathogens in the community is greater than 10% to 20%.
What is the quickest antibiotic for UTI?Which antibiotic gets rid of a UTI fastest?. Sulfamethoxazole/trimethoprim is a first-choice medication and can treat a UTI in as little as 3 days. ... . Nitrofurantoin is another first-choice option for UTIs, but you typically have to take it for a week to be sure you are all better.. Is there an alternative to antibiotics for UTI?Oral probiotics (live microorganisms) or vaginal suppositories may soon be a new alternative to antibiotics. Bacteriophages may also be an option in the future. Just like antibiotics, bacteriophages can get rid of harmful bacteria in the urinary tract — but with a more targeted attack.
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