A urinary tract infection (UTI), also called a bladder infection is common among adults, especially females and also occasionally occurs in children. UTI has symptoms including painful and frequent urination, cloudy or smelly urine and may progress to lower back pain, fatigue and fever if left untreated. UTI is generally treated with one of a number of prescription antibiotics.
Sulfamethoxazole / Trimethoprim
The combination drug sulfamethoxazole with trimethoprim (SMZ/TMP) has long been the first line treatment for uncomplicated urinary tract infections, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It has been considered to be effective against E. coli bacteria which causes up to 90 percent of all UTIs and can be used in most patients of all ages. SMZ/TMP may cause allergic reactions in those who are sensitive to sulfa drugs. In addition, SMZ/TMP should be taken with a full glass of water to avoid the possibility of the drug crystallizing in the urine.
Fluoroquinolones
The fluoroquinolone class of antibiotics includes medications such as ciprofloxacin, levofloxacin and moxifloxacin are often used to treat UTI, particularly if other medications have failed to resolve the infection. Fluoroquinolones should not be taken by pregnant or breastfeeding women and limited use in children is advised due to the possibility of increased side effects such as bone development problems. Fluoroquinolones should not be taken at the same time as foods or supplements containing iron or calcium due to the inactivation of the antibiotic.
Penicillins and Cephalosporins
Penicillins such as penicillin V and amoxicillin along with the related class of medications, cephalosporins including antibiotics such as cefaclor and cephalexin have been used in cases where the patient cannot take other more commonly used UTI antibiotics. Penicillins and cephalosporins may be an alternative for pregnant or breastfeeding women and children due to the possibility of side effects from other classes of drugs. Penicillins and cephalosporins may cause mild stomach upset which may often be minimized by taking the medication with food. Diarrhea is also a common complaint associated with many antibiotics. Some patients may be allergic to penicillins or cephalosporins and should not take either type of medication.
Tetracyclines
Tetracycline and a related medication, doxycycline may be used for the treatment of UTI when other medications cannot be taken due to side effects or allergies. Tetracyclines are not considered to be first line therapy but may prove useful in some patients. Tetracycline should not be taken by pregnant or breastfeeding women or by children under the age of 8 because tetracycline will stain developing teeth a gray color. Tetracyclines should also not be taken with calcium or iron containing products or food due to the inactivation of the antibiotic.
Nitrofurantoin
Nitrofurantoin is a medication specifically for the treatment of UTI. It is effective in some people but may not treat all types of UTI but may be used as a prophylaxis medication to prevent return of recurrent UTI. In addition, nitrofurantoin may need to be taken up to four times daily by some patients which may make it inconvenient. It may cause liver or kidney damage in some patients, particularly those who have preexisting conditions or take the medication for a long period of time. The physician may require blood testing while taking this medication.
Aminoglycosides
Aminoglycoside antibiotics such as gentamicin or tobramycin may be given intravenously in cases of severe infection which has not responded to other medications, according to the University of Maryland Medical Center. Use of these antibiotics will most likely require hospitalization as they may pose risks such as kidney and hearing damage. Lab tests will likely be performed to ensure appropriate blood concentration of the antibiotics before and after a dose and to ensure that the kidney is functioning well.
