Table of Contents
The typical treatment for an uncomplicated UTI is a 3-day course of the combination drug trimethoprim-sulfamethoxazole, commonly called TMP-SMX (such as Bactrim, Cotrim, or Septra). A 1-day course is somewhat less effective but poses a lower risk for side effects. Longer courses (7 - 10 days) work no better than the 3-day course and have a higher rate of side effects.
TMP-SMX should not be used in patients who are allergic to sulfa drugs. Allergic reactions can be very serious. Trimethoprim (such as Proloprim or Trimpex) is sometimes used alone in those allergic to sulfa drugs. TMP-SMX can interfere with the effectiveness of oral contraceptives. High rates of bacterial resistance to TMP-SMX exist in many parts of the United States.
Fluoroquinolones (Quinolones)
Fluoroquinolones (also simply called quinolones) are now becoming as widely used as TMP-SMX. They are the standard alternatives to TMP-SMX. Examples of quinolones include ofloxacin (Floxacin), ciprofloxacin (Cipro), norfloxacin (Noroxin), and levofloxacin (Levaquin). These drugs can have severe side effects, however, that the patient should discuss with the doctor.
Pregnant women should not take fluoroquinolone antibiotics. They also have more adverse effects in children than other antibiotics and should not be the first-line option in most pediatric situations.
Tetracyclines
Tetracyclines include doxycycline, tetracycline, and minocycline. Treatment with tetracycline or doxycycline may be used for infections that are caused by Mycoplasma or Chlamydia. Tetracyclines have unique side effects among antibiotics, including skin reactions to sunlight, possible burning in the throat, and tooth discoloration. They cannot be taken by children or pregnant women.
Aminoglycosides
Aminoglycosides (gentamicin, tobramycin, amikacin) are given by injection for very serious bacterial infections. They can be given only in combination with other antibiotics. Gentamicin is the most commonly used aminoglycoside for severe UTIs. They can have very serious side effects, including damage to hearing, sense of balance, and kidneys.
Other Antibiotics Used Specifically for UTIs
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Review Date: 06/17/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
