Medication Options to Treat Urinary Tract Infections (UTIs)

What Are Drugs For Treating UTIs?

Urinary tract infections (UTIs) can be treated with several types of medications. Each medication works differently to help treat UTIs, and it's important to be aware of the precautions and potential side effects associated with each one.

Here are some examples of medications used to treat UTIs, including how they work, key precautions, and potential side effects. The best choice depends on the type of UTI, symptom severity, pregnancy status, kidney function, allergies, prior urine culture results, and local antibiotic-resistance patterns.

Trimethoprim [trye-METH-oh-prim] or sulfamethoxazole [sul-fa-meth-OX-a-zole]:

Effect: Trimethoprim-sulfamethoxazole, also called TMP-SMX, is an antibiotic combination that may be used for uncomplicated UTIs when the bacteria are expected to be susceptible. It works by blocking steps bacteria need to make folate, which helps stop bacterial growth.
Precautions: Take this medication exactly as prescribed and complete the full course unless your healthcare professional tells you otherwise. It may not be appropriate for people with a sulfa allergy, certain kidney problems, significant liver disease, some blood disorders, or during some stages of pregnancy. It can also interact with medicines such as warfarin, certain blood pressure medicines, diuretics, and methotrexate, so tell your healthcare professional about all medicines and supplements you take.
Potential side effects: Possible side effects include nausea, vomiting, diarrhea, loss of appetite, rash, itching, and sensitivity to sunlight. Rare but serious reactions can include severe skin reactions, allergic reactions, blood-count changes, liver problems, kidney problems, or high potassium. Seek medical care promptly for a widespread rash, trouble breathing, swelling, severe diarrhea, yellowing of the skin or eyes, unusual bruising or bleeding, or symptoms that worsen or do not improve.

Nitrofurantoin [nye-troe-fyoor-AN-toyn]:

Effect: Nitrofurantoin is commonly used as a first-line treatment for uncomplicated lower UTIs, such as bladder infections, when appropriate. It concentrates in the urine and damages bacterial cells, helping stop the infection.
Precautions: Nitrofurantoin is usually taken with food to improve absorption and reduce stomach upset. It is generally used for lower UTIs and is not appropriate for suspected kidney infection or bloodstream infection. It may not be suitable for people with significantly reduced kidney function, certain liver conditions, or a history of lung or nerve problems related to nitrofurantoin. Tell your healthcare professional if you are pregnant, breastfeeding, or have kidney, liver, lung, or nerve disease.
Potential side effects: Common side effects may include nausea, headache, gas, loss of appetite, and darker yellow or brown urine. Rare but serious side effects can include lung inflammation, liver injury, nerve damage, or severe allergic reactions. Contact your healthcare professional if you develop shortness of breath, chest pain, persistent cough, numbness or tingling, severe weakness, yellowing of the skin or eyes, or severe or persistent side effects.

Fosfomycin [fos-foe-MYE-sin]:

Effect: Fosfomycin is an antibiotic that may be used for uncomplicated lower UTIs caused by susceptible bacteria. It works by interfering with bacterial cell-wall formation. It is often given as a single-dose treatment, depending on the clinical situation and local guidance.
Precautions: Fosfomycin is generally used for lower UTIs and is not appropriate for suspected kidney infection or bloodstream infection. Tell your healthcare professional if you are pregnant, breastfeeding, have kidney disease, or if symptoms do not improve after treatment.
Potential side effects: Possible side effects include diarrhea, nausea, headache, dizziness, stomach pain, vaginal itching or discharge, and rash. Contact your healthcare professional if side effects are severe or persistent, or if fever, back pain, worsening symptoms, or recurrent symptoms occur.

Ciprofloxacin [sip-row-FLOX-a-sin] and levofloxacin [LEE-voe-FLOX-a-sin]:

Effect: Ciprofloxacin and levofloxacin are fluoroquinolone antibiotics. They kill bacteria by interfering with bacterial DNA processes. Because of safety concerns and the risk of promoting antibiotic resistance, they are not usually first-choice options for uncomplicated UTIs and are generally reserved for selected cases, such as complicated UTIs, suspected kidney infection, or when other appropriate antibiotics cannot be used.
Precautions: Tell your healthcare professional about all medicines and supplements you take. Fluoroquinolones can interact with antacids, iron, zinc, calcium supplements, some heart-rhythm medicines, diabetes medicines, steroids, and blood thinners. They should be used with caution in people with a history of tendon problems, seizures, nerve problems, certain heart-rhythm conditions, myasthenia gravis, aortic aneurysm or risk factors for aneurysm, or significant kidney disease. Avoid taking them at the same time as mineral supplements or antacids unless your healthcare professional gives specific timing instructions.
Potential side effects: Common side effects may include nausea, diarrhea, headache, dizziness, trouble sleeping, and sensitivity to sunlight. Rare but serious side effects can include tendon inflammation or rupture, nerve damage, changes in mood or thinking, severe low or high blood sugar, heart-rhythm changes, severe allergic reactions, and worsening muscle weakness in people with myasthenia gravis. Stop the medicine and seek medical advice promptly if you develop tendon pain or swelling, numbness or tingling, severe dizziness, fainting, confusion, hallucinations, severe diarrhea, or signs of an allergic reaction.

Prophylactic antibiotics:

Effect: Prophylactic antibiotics may be used for people with recurrent UTIs, often defined as two or more UTIs in 6 months or three or more UTIs in 12 months. They are intended to reduce the chance of future infections, usually after other prevention strategies have been considered. Depending on the pattern of infections, a healthcare professional may recommend a low-dose antibiotic taken daily, after sex if UTIs are linked to sexual activity, or as a patient-initiated treatment plan when symptoms begin.
Precautions: Prophylactic antibiotics should only be used under the guidance of a healthcare professional. Recurrent UTIs should be confirmed, and the choice of antibiotic should be based on factors such as prior urine culture results, allergies, kidney function, pregnancy status, other medicines, and local antibiotic-resistance patterns. Long-term or repeated antibiotic use can increase the risk of antibiotic resistance, so prophylaxis should be reviewed periodically to determine whether it is still needed.
Potential side effects: Side effects depend on the antibiotic used but may include nausea, diarrhea, stomach upset, yeast infection, rash, or allergic reaction. Rare but serious side effects can occur with some antibiotics. Contact your healthcare professional if side effects are severe, persistent, or concerning, or if symptoms of a UTI continue or return despite prevention treatment.

It's worth noting that while medications can effectively treat UTIs, it's always essential to consult with a healthcare professional before starting any treatment. They can evaluate your specific situation and provide personalized recommendations based on your medical history and individual needs.