Urinary tract infections result from the invasion of the urinary tract by bacteria. Each year in the United States, approximately 6 to 8 million urinary tract infections develop, and Escherichia coli causes more than 80 percent of them, according to the Centers for Disease Control and Prevention. Escherichia coli, commonly abbreviated as E. coli, normally lives in the digestive system but sometimes migrates to the urinary tract and causes infections. Several treatments are available for urinary tract infections caused by E. coli.
Fluids
All patients with a urinary tract infection should drink extra fluids. Patients can sometimes cure mild infections simply by drinking large volumes of water, which help the body to flush out E. coli, explains the Penn State College of Medicine. Even if a urinary tract infection is more severe, doctors always recommend drinking plenty of fluids, because the extra fluids flowing through the urinary tract can increase the effectiveness of other treatments.
Trimethoprim and Sulfamethoxazole
Doctors treat most urinary tract infections caused by E. coli with antibiotics. Standard treatment is a 3-day prescription of a combination of the drugs trimethoprim and sulfamethoxazole, commonly called TMP-SMX, reports the University of Maryland Medical Center. Patients who are allergic to sulfa drugs are sometime prescribed trimethoprim alone. Patients who recently had dental surgery should not take TMP-SMX. Even though the symptoms of a urinary tract infection may disappear after one or two days, patients must take the entire prescription. Otherwise, only some of the bacteria may be killed, and those that remain can begin to reproduce again and cause an even more severe infection.
Beta-Lactam Antibiotics
A doctor may also prescribe medications from a family of drugs called beta-lactams to treat urinary tract infections caused by E. coli. Penicillins, especially amoxicillin, used to be the standard treatment for urinary tract infections. Because it has been so widely used, however, approximately 25 percent of E. coli infections are resistant to amoxicillin, according to the University of Maryland Medical Center. In cases of drug resistance, doctors may prescribe other beta-lactam drugs, including cephalosporins and pivmecillinam.
Fluoroquinolones
Because of increased use of TMP-SMX to treat urinary tract infections, some strains of E. coli are developing resistance to it. Fluoroquinolones---a group of drugs sometimes called just quinolones---are an alternative to TMP-SMX. Common types of quinolones include ofloxacin, ciprofloxacin, norfloxacin and levofloxacin.
Treatments for Severe Infections
If patients do not seek early treatment for urinary tract infections, the infection can spread to the kidneys and cause severe complications, such as the inability to drink fluids or take medications. Patients with severe infections may require hospitalization so that they can receive intravenous fluids, the National Kidney and Urologic Diseases Information Clearinghouse explains. Aminoglycoside antibiotics, including gentamicin, tobramycin and amikacin, are drugs used specifically for treating severe urinary tract infections. Another recently developed antibiotic called doripenem is also effective in severe infections with complications. Doctors give doripenem as in injection instead of orally, which is the route of administration of most other antibiotics used to treat urinary tract infections.
References
- Centers for Disease Control and Prevention: Food Reservoir for Escherichia coli Causing Urinary Tract Infections
- University of Maryland Medical Center: Urinary tract infection - Medications
- National Kidney and Urologic Disease Information Clearinghouse:Urinary Tract Infections in Adults
- Penn State College of Medicine: Urinary Tract Infections (UTI)
- Georgia Health Info: Urinary tract infection
