Urinary tract infections result when bacteria, such as Eschericia coli or the entrococci family of bacteria, get into the urinary tract. Urinary tract infections in males typically occur in older men, particularly men with prostate problems. Men who have recently had a catheter or other device inserted into their urinary tract are also at increased risk. According to the European Association of Urology, most male urinary tract infections can be treated with similar antibiotic regimens as those used for women.
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One option for treating a urinary tract infection in men is a 7-day course of sulfonamide antibiotics. One commonly used sulfonamide treatment is a combination of trimethoprim and sulfamethoxazole, also known as Bactrim. Bactrim is typically taken twice per day and should be taken with plenty of fluids. In some cases, bacteria can be resistant to Bactrim. In general, doctors will look at reports regarding bacterial resistance to antibiotics in the community to decide if Bactrim will work. If less than 10 percent of urinary tract infections in the community are resistant to Bactrim, then Bactrim is an appropriate initial treatment.
A 7-day course of a fluoroquinolone, such as ciprofloxacin (Cipro) or ofloxacin (Floxin), can also be used to treat a urinary tract infection in a male patient. Fluoroquinolones can be used if many cases of urinary tract infections in the community are resistant to Bactrim. Fluoroquinolones are best when taken 2 hours after a meal. Common side effects include nausea, abdominal pain or discomfort, headache and diarrhea. In rare cases, a serious allergic reaction can occur after taking a fluoroquinolone; it can cause swelling of the face and limbs, shortness of breath, tingling, itching and sudden collapse of the circulatory system.
Beta-lactam antibiotics, which include the cephalosporin group of antibiotics, can also be used to treat a urinary tract infection in men. For example, the cephalosporin known as cefpodoxime (Vantin) is as effective as Bactrim at treating urinary tract infections. Another beta-lactam antibiotic that can be used is pivmecillinam. Although these antibiotics may be as effective as fluoroquinolones or Bactrim for urinary tract infections in men, not enough studies have compared their effectiveness to fluoroquinolones or Bactrim.
Urinary tract infections in men are commonly considered "complicated," as they generally only occur in infants and elderly men with a blockage in the urinary tract or some other abnormality. As a result, men usually need to take antibiotics for longer than women with urinary tract infections. In addition, men should not use the antibiotic nitrofurantoin, which is commonly used to treat urinary tract infections in women, because the concentrations achieved in the the male urinary tract are too low.
- Current Medical Diagnosis and Treatment 2013; Maxine Papadakis
- American Family Physician: Urinary Tract Infections in Adults
- Physician Desk Reference Family Guide to Prescription Drugs
- European Association of Urology: The Management of Urinary and Male Genital Tract Infections
- Journal for Nurse Practitioners: Evidence-Based Management of Urinary Tract Infections Across the Lifespan -- Current Update