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Treatment For Uncomplicated Utis

Antibiotic Awareness: Urinary Tract Infection (UTI), Cystitis or Bladder Infection

If youre an otherwise healthy woman who isnt pregnant and hasnt entered menopause, your doctor may prescribe one of the following antibiotics to resolve an uncomplicated UTI.

1. Trimethoprim or Trimethoprim-Sulfamethoxazole

These synthetic, oral antibiotics often shortened to TMP and TMP-SMX are common first options for treatment due to their cost and their efficacy. A three-day regimen is typical.

Typical dose: 100-milligram tablet every 12 hours or 200-milligram tablet every 24 hours

Most common side effects:

  • Rash

2. Fosfomycin

Fosfomycin distinguishes itself from the other antibiotics on this list by the fact that a single dose may be all thats required to clear up some patients UTIs. Although less frequently prescribed in the United States, it has been a common treatment option in Europe since the late 1980s.

Fosfomycin also stands out because its available as a powder. Patients dissolve the contents of a prescribed powder packet in 4 ounces of water, then drink it immediately.

Typical dose: 3 grams

Most common side effects:

  • Thick, white discharge
  • Pain during intercourse

3. Nitrofurantoin

Nitrofurantoin is another route your doctor might take, and its available as a capsule or a liquid. The main difference between this antibiotic and those listed above is that it requires five to seven days to work. Because its been shown to exacerbate preexisting pulmonary issues, its typically not recommended for use by elderly patients.

Common side effects:

5. ß-Lactams

Do You Need To See A Doctor To Get Antibiotics For A Uti

You need to speak with your doctor or a licensed medical professional to be prescribed antibiotics for a UTI. This can usually be done in person, at the doctor, or over the phone.

If this is your first UTI or your symptoms are severe, it may be helpful to get treated in person. You may also want to consider an in-person visit with your healthcare professional to rule out sexually transmitted infections if you are sexually active or have multiple sexual partners.

Will I Need An Intravenous Antibiotic For A Uti

If you are pregnant, have a high fever, or cannot keep food and fluids down, your doctor may admit you to the hospital so you can have treatment with intravenous antibiotics for a complicated UTI. You may return home and continue with oral antibiotics when your infection starts to improve.

In areas with fluoroquinolone resistance exceeding 10%, in patients with more severe pyelonephritis, those with a complicated UTI who have allergies to fluoroquinolones, or are unable to tolerate the drug class, intravenous therapy with an agent such as ceftriaxone, or an aminoglycoside, such as gentamicin or tobramycin, may be appropriate. Your ongoing treatment should be based on susceptibility data received from the laboratory.

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Uncomplicated Cystitis In Nonpregnant Patients

Uncomplicated cystitis occurs in patients who have a normal, unobstructed genitourinary tract who have no history of recent instrumentation and whose symptoms are confined to the lower urinary tract. Uncomplicated cystitis is most common in young, sexually active women. Patients usually present with dysuria, urinary frequency, urinary urgency, and/or suprapubic pain. Treatment regimens for uncomplicated cystitis in nonpregnant women are provided in Table 1, below.

References
  • Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar. 52:e103-20. . .

  • Wagenlehner FM, Schmiemann G, Hoyme U, Fünfstück R, Hummers-Pradier E, Kaase M, et al. . Urologe A. 2011 Feb. 50:153-69. . .

  • Abrahamian FM, Moran GJ, Talan DA. Urinary tract infections in the emergency department. Infect Dis Clin North Am. 2008 Mar. 22:73-87, vi. .

  • Little P, Turner S, Rumsby K, Warner G, Moore M, Lowes JA, et al. Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study. Health Technol Assess. 2009 Mar. 13:iii-iv, ix-xi, 1-73. .

  • Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010 Dec. 7:653-60. .

  • Editorial Sources And Fact

    ASK DIS: Urinary Tract Infection: Antibiotics in Adults
  • R Orenstein R, Wong ES. Urinary Tract Infections in Adults. American Family Physician. March 1999.
  • Anger J, Lee U, Ackerman AL, et al. Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline. The Journal of Urology. August 2019.
  • Patient Education: Urinary Tract Infections in Adolescents and Adults . UpToDate. January 2020.
  • Huttner A, Kowalczyk A, Turjeman A, et al. Effect of 5-Day Nitrofurantoin vs Single-Dose Fosfomycin on Clinical Resolution of Uncomplicated Lower Urinary Tract Infection in Women a Randomized Clinical Trial. Journal of the American Medical Association. May 2018.
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    Antibiotics Used For Uncomplicated Utis

    If you are a healthy individual whose urinary tract is anatomically and functionally normal and you have no known heightened UTI susceptibility youve got whats dubbed an uncomplicated UTI, according to guidelines published in August 2019 in the Journal of Urology. For these individuals, antibiotics are considered the first-line of treatment.

    The type of antibiotics you are prescribed and for how long is contingent on the type of bacteria detected in your urine, your current health status, and whether your UTI is uncomplicated or complicated. Depending on which antibiotic your doctor prescribes, women may need a single dose or up to a five-day course. For men, antibiotics are usually given for a slightly longer period of time, notes UpToDate.

    Typically, if you are diagnosed with an uncomplicated UTI, one of the following will be prescribed as first-line treatment:

    The following antibiotics are considered second-line treatments for UTI. They are generally chosen because of resistance patterns or allergy considerations:

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    What Are The Signs That An Antibiotic Is Not Working For A Urinary Tract Infection

    Usually people start to feel better within 1-2 days of starting an antibiotic to treat a bladder infection. If your symptoms dont improve or you start to feel worse then your antibiotic may not be working.

    The symptoms of an uncomplicated bladder infection typically include:

    • Pain or a burning sensation when you urinate or pee
    • Needing to pee frequently
    • Feeling like you need to pee within minutes of going
    • Blood stained pee
    • Feeling pressure or cramping in your lower abdomen

    If your antibiotic is not working then these symptoms will likely continue and you may even develop symptoms of a more serious kidney infection including:

    • Fever
    • Pain in your lower back or side
    • Nausea and vomiting

    Left untreated, kidney infections can permanently damage the kidneys and can sometimes become life-threatening.

    Kidney infections are usually treated with a longer 7-14 day course of antibiotics and in more severe or complicated cases may require treatment with intravenous antibiotics and admission to hospital. If you have a kidney infection it may take you a few more days to feel better after you start antibiotics.

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    Is There Any Other Way To Prevent A Uti

    While theres no foolproof way to ensure you never have a UTI, there are strategies and behaviors that may lower your risk:

    • Stay hydrated.
    • Women should wipe from front to back to stop the spread of bacteria.
    • Avoid using douches, powders, sprays or other materials in the genital area.

    Some physicians have begun recommending that patients add probiotics to their diet such as kefir, yogurt, various fermented foods, etc. as a form of prevention. No evidence indicates that probiotics can prevent a UTI on their own, but they do promote the growth of helpful bacteria in the vagina and bowels, which is beneficial for your overall health and may lower your risk of infection.

    UTIs are commonplace so commonplace, in fact, that theyre one of the most frequently treated issues by telehealth professionals. If youre experiencing symptoms consistent with a UTI, dont wait until your schedule clears up to make an appointment with a physician. Dont wait for your doctors next in-office opening six weeks from now, either.

    Daily Antibiotics Most Effective In Preventing Recurrent Urinary Tract Infection

    Ask Dr. Nandi: Antibiotic-resistant urinary tract infections are on the rise
    Date:
    Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
    Summary:
    While daily antibiotic use is the most effective method for preventing recurrent urinary tract infections in women, daily cranberry pills, daily estrogen therapy and monthly acupuncture treatments also have benefits that may be preferable for some patients.

    While daily antibiotic use is the most effective method for preventing recurrent urinary tract infections in women, daily cranberry pills, daily estrogen therapy and monthly acupuncture treatments also have benefits that may be preferable for some patients, according to a new study by researchers at the Los Angeles Biomedical Research Institute .

    The study, published in the Jan. 15 issue of the journal, Clinical Infectious Diseases, said more than half of women suffer from a urinary tract infection at some time in their lives, often requiring antibiotics or other treatments to recover from the infections.

    A smaller group of women will have three or more urinary tract infections per year and may require a more pro-active course of treatment to prevent these recurrent infections. The LA BioMed study is the first to use a modeling approach to compare the effectiveness of all of the most commonly used prophylactic measures.

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    What Is A Uti

    Before we talk about the antibiotics that treat UTIs, lets discuss what the medications are targeting.

    Urinary tract infections, or UTIs, refer to a group of infections that can happen anywhere along the urinary tract, which includes the kidneys, ureters, bladders, and urethra. Antibiotics are used to treat UTIs because bacteria often cause themEscherichia coli is the type of bacteria notoriously famous for causing most UTIs.

    Most germs that cause these infections typically live on the skin in unharmful numbers, especially in areas like the vaginal folds. However, once in the urinary tract, they can multiply to unsafe colony numbers and cause symptoms .

    UTI symptoms include: burning during urination, needing to pee frequently, lower abdominal pain or cramping, blood in your urine, and feeling the need to urinate even if you just went to the bathroom.

    Increase Your Intake Of Horseradish And Garlic

    Herbs such as garlic and horseradish are high on antiseptic properties.

    Horseradish is known for being one of the best natural antibiotic, widely used in treating kidney stones, gallbladder disorders, intestinal worms and fluid retention.

    Garlic exhibits antibiotic properties that can produce a diuretic effect, and this has become a popular method to treat UTI at home.

    Increase your consumption of horseradish and garlic by eating more salads that contain these herbs in large amounts.

    Besides salads,

    • You can up the intake of horseradish by boosting its use in preparing roast beef sandwich and gefilte fish dishes.
    • Try adding honey garlic to your roasted beef, pork chops, fried cabbage and chicken
    • A drink of Bloody Mary contains horseradish in ample amounts and can be consumed more through its non-alcoholic variant, Virgin Mary.

    These herbs horseradish and garlic can clear up the urinary tract from infections by fighting the bacterial growth. For faster results, you can eat raw garlic and horseradish till your UTI pain goes away.

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    What About Cranberry Juice For Uti

    Its a long-held belief that consuming cranberry juice may help prevent and treat urinary tract infections. While its true that cranberries contain an active ingredient that can prevent adherence of bacteria to the urinary tract, there is still no evidence that cranberry products can treat a UTI.

    One of the reasons: Products like cranberry juice or cranberry capsules are not explicitly formulated with the same amount of PACs that have shown potential in lab studies. Moreover, a 2019 report in the Journal of Urology noted that the availability of such products to the public is a severe limitation to the use of cranberries for UTI prophylaxis outside the research setting.

    In all, theres actually very little high-quality research on the topic of prevention. For instance, a 2016 study in The Journal of the American Medical Association, found that among female nursing home residents, daily consumption of cranberry capsules resulted in no significant prevention of UTIs.

    While consuming cranberry juice or supplements is not considered a first-line treatment of urinary tract infections, in most cases, it cant hurt. After all, drinking plenty of liquids does dilute your urine and help spur more frequent urination, which flushes bacteria from the urinary tract. The exception: Those who are taking blood-thinning medication, such as warfarin, should not consume cranberry juice. And those with diabetes should be mindful of the high-sugar content of fruit juices.

    Monitoring Response To Therapy

    Antibiotics recommended for the treatment of urinary tract infections ...

    Patients with a simple, uncomplicated UTI may not require rigorous monitoring. However, patients with complicated, relapsing, or recurrent infections should be monitored very closely. The following protocol is recommended to monitor response to therapy in patients with relapsing, recurrent, or refractory UTI.3

  • Recheck urine culture 5 to 7 days into antibiotic therapy. This confirms that the prescribed dose and frequency of the drug were successful in treating the organism isolated. This culture also may reveal an additional isolate that could not be identified in the initial culture. Any bacterial growth observed at this time suggests treatment failure. Reconsider the choice of antibiotic, dose, and administration frequency.
  • Recheck urine culture 3 days before discontinuing antibiotic therapy. This is an optional step, but it confirms that, when therapy was discontinued, the patient still had a negative culture. Positive bacterial growth at this stage suggests a refractory infection or newly inoculated organism. Investigate patients for any nidus of infection . Alter treatment and institute new therapy for the same duration as previously intended.
  • Recheck urine culture 7 days after discontinuing antibiotic therapy. Positive growth should prompt investigation for causes of relapse or reinfection.
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    What Oral Antibiotics Are Used To Treat An Uncomplicated Uti In Women

    The following oral antibiotics are commonly used to treat most uncomplicated UTI infections :

    Your doctor will choose your antibiotic based on your history, type of UTI, local resistance patterns, and cost considerations. First-line options are usually selected from nitrofurantoin, fosfomycin and sulfamethoxazole-trimethoprim. Amoxicillin/clavulanate and certain cephalosporins, for example cefpodoxime, cefdinir, or cefaclor may be appropriate options when first-line options cannot be used.

    Length of treatment for cystitis can range from a single, one-time dose, to a course of medication over 5 to 7 days. Kidney infections may require injectable treatment, hospitalization, as well as a longer course of antibiotic, depending upon severity of the infection.

    Sometimes a UTI can be self-limiting in women, meaning that the body can fight the infection without antibiotics however, most uncomplicated UTI cases can be treated quickly with a short course of oral antibiotics. Never use an antibiotic that has been prescribed for someone else.

    In men with symptoms that do not suggest a complicated UTI, treatment can be the same as women. In men with complicated UTIs and/or symptoms of prostatitis are not present, men can be treated for 7 days with a fluoroquinolone . Tailor therapy once urine cultures are available.

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    Data Extraction And Quality Assessment

    One reviewer extracted study characteristics and outcome data from included trials. We contacted two authors for subgroup data on postmenopausal women. One author replied and provided relevant outcome data. Two reviewers independently assessed the risk of bias of the included studies using the Cochrane Collaborations risk of bias tool. Disagreements were resolved through discussion. We used RevMan V.5.3 to meta-analyse the data and generate forest plots.

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    Recurrent Uti And Menopause May Be Linked By Estrogen Levels

    So where does estrogen come in? How are UTI and menopause linked?

    It is thought that estrogen increases the stores of glycogen on the surface of the vaginal epithelial cells .

    Glycogen acts as a food source for Lactobacilli. The more glycogen that is available, the more the Lactobacilli eat, and the more they multiply. And as mentioned above, abundant Lactobacilli provide a lactic acid rich, protective environment.

    When females go through menopause and the levels of estrogen are reduced, this food source also diminishes, and so do the Lactobacilli and accompanying protective acid.

    What Is Gall Bladder Infection

    What are some common antibiotics used to treat UTIs?

    Our gallbladder is an essential organ, even for its small pear size, of our body for it stores essential component bile. The liver produces the bile that is vital in fat digestion and the color of our excreta. When an infection arises, it is said to be quite difficult to bear and shall need to be surgically intervened. The importance of the gallbladder is somehow taken for granted that is why many are unaware that they have damaged this organ. The bile that is being stored in the gallbladder serves as an emulsifier of the fats, making it into a soluble solution, now viable for the body as our fuel. When we eat food rich in fats, the gallbladder is responsible in the release of the right amount of bile for the fat emulsification. The condition is also referred as acute cholecystitis.

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    Diagnosing Urinary Tract Infections

    Urine cultures and urinalysis can detect urinary tract infections throughout a womans pregnancy . The American College of Obstetrics and Gynecology recommends that a urine culture is obtained at the first prenatal visit . A repeat urine culture should be obtained during the third trimester because the urine of treated patients may not remain sterile throughout the entire pregnancy. The recommendation of the U.S. Preventive Services Task Force is to obtain a urine culture between 12 and 16 weeks of gestation . Urine cultures are preferred to the office-based screening tests, such as a urinalysis and dipstick testing, which lack sufficient sensitivity and specificity.

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