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Antibiotics For Urinary Tract Infection In Females

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Ask Dr. Nandi: Antibiotic-resistant urinary tract infections are on the rise

While UTIs arent usually a cause for major concern, if you dont get them treated, they can lead to more serious problems like a kidney infection. If you have a UTI, make an appointment with a healthcare provider as soon as possible. The fastest way to feel better is by taking an antibiotic to kill the bacteria causing your infection.

If going to see a provider in-person is not an option , there are plenty of telehealth services available that will allow you to set up a virtual appointment. Check out GoodRx Care for treatment of UTIs as well as many other medical conditions.

During your appointment, your provider will ask you questions about what symptoms you are experiencing and if you are prone to UTIs. You might be asked to provide a urine sample either in the office you are seen in or at a lab close to you. Lastly, your provider will prescribe you a course of antibiotics to get started on right away.

Some common antibiotics used for treating UTIs include nitrofurantoin , sulfamethoxazole/trimethoprim , and ciprofloxacin . Typically, you only need to take them for 3 to 5 days, and most people start to feel relief within the first 2 to 3 days. Antibiotics can cause nausea, stomach upset, and diarrhea for many people. But, taking your dose with food can help lessen nausea and stomach upset, and taking a probiotic supplement like L. acidophilus can help with the diarrhea.

International And Domestic Recommendations

According to American Urological Association , Canadian Urological Association , and Society of Urodynamics , Female Pelvic Medicine, and Urogenital Reconstruction guidelines, most recommendations are classified as level B or C . Diagnosis of recurring UTI should always be confirmed by a urine culture. Prior to treatment initiation, the practitioner should review urinalysis and urine culture results. In case of very severe symptoms, however, antibiotic treatment may be initiated while waiting for laboratory test results. Asymptomatic bacteriuria should not be treated it does not necessitate urinalyses or urine cultures, either. Antibiotic treatment of symptomatic UTI should follow the results of an antibiogram. Antibiotic treatment should not exceed 7 days, and it may be administered parenterally whenever required. If symptoms recede, no post-treatment laboratory tests are required. If symptoms persist, a repeat urine culture should be carried out to guide further treatment. Topical vaginal administration of oestrogens is recommended in post- and perimenopausal women . In accordance with the WHO plan to counteract inducing excessive antibiotic resistance, the aforementioned research associations permit prophylactic use of cranberry and other alternative therapies.

Editorial Sources And Fact

  • 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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    Which Antibiotic Should Be Used To Treat A Uti

    There are multiple types of antibiotics used to treat urinary tract infections . Different treatments may be recommended in different areas of the country based on regional patterns of antibiotic resistance.

    Most patients with an uncomplicated UTI will begin treatment without any special diagnostic test, although a urinalysis may be performed by taking a urine sample. In a urinalysis, the chemical components of the urine are determined, and the doctor may look at urine color, clarity, and a view a sample under the microscope. A urine culture may be order, too, but is not always needed to start treatment. A urine culture can define the specific bacteria causing the UTI in more complicated cases or in the case of treatment failure.

    Symptoms like burning and stinging while urinating will usually clear up in within one day after starting treatment. Be sure to finish your entire course of medication. If symptoms are still present after 2 to 3 days, contact your healthcare provider.

    More extensive diagnostic procedures or imaging tests like an X-ray may be required if you continue to have frequent UTIs.

    Can Urinary Tract Infections Be Prevented Or Avoided

    Quick Relief From Your Urinary Tract Infection (UTI)Causes and ...

    There are many lifestyle choices that can help you prevent UTIs. These are some of the things you can do to protect yourself from them:

    • Drink plenty of water to flush out bacteria. For some people, drinking cranberry juice may also help prevent urinary tract infections. However, if youre taking warfarin, check with your doctor before using cranberry juice to prevent urinary tract infections. Your doctor may need to adjust your warfarin dose or you may need to have more frequent blood tests.
    • Dont hold your urine. Urinate when you feel like you need to. Some children dont go to the bathroom often enough. If your child does this, teach him or her to go to the bathroom several times each day.
    • Wipe from front to back after bowel movements. Teach your child to wipe correctly.
    • Urinate after having sex to help wash away bacteria.
    • Use enough lubrication during sex. Try using a small amount of lubricant before sex if youre a little dry.
    • If you get urinary tract infections often, you may want to avoid using a diaphragm as a birth control method. Ask your doctor about other birth control choices.
    • Avoid taking or giving your child bubble baths.
    • Wear loose-fitting clothing , and dress your child in loose-fitting clothing.
    • If you are uncircumcised, wash the foreskin regularly. If you have an uncircumcised boy, teach him how to wash his foreskin.

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    What Is The Prognosis For A Person With A Urinary Tract Infection

    Urinary tract infections typically respond very well to treatment. A UTI can be uncomfortable before you start treatment, but once your healthcare provider identifies the type of bacteria and prescribes the right antibiotic medication, your symptoms should improve quickly. Its important to keep taking your medication for the entire amount of time your healthcare provider prescribed. If you have frequent UTIs or if your symptoms arent improving, your provider may test to see if its an antibiotic-resistant infection. These are more complicated infections to treat and may require intravenous antibiotics or alternative treatments.

    How Common Are Urinary Tract Infections

    Urinary tract infections are very common, occurring in 1 out of 5 women sometime in their lifetime. Though UTIs are common in women, they can also happen to men, older adults and children. One to 2% of children develop urinary tract infections. Each year, 8 million to 10 million visits to doctors are for urinary tract infections.

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    Creating Stronger Strains Of Bacteria

    Over time, some species of bacteria have become resistant to traditional antibiotics. According to some research , several species of E. coli, the primary cause of UTIs, are showing increasing drug resistance.

    The more a person uses an antibiotic, the greater the risk of the bacteria developing resistance. This is even more likely when people do not follow a doctors instructions to complete the full prescribed course of treatment.

    It is essential to continue a course of antibiotics until the end date that the doctor provides. People should also never share antibiotics with others.

    Can Uti Symptoms Linger After I Take Antibiotics

    Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/ CUA/ SUFU Guideline 2019

    Since UTI symptoms usually improve just a few days after starting antibiotics, youll want to talk to your healthcare provider if you notice that UTI symptoms are still hanging around after finishing your antibiotics.

    Theres no need to panic, but you and your healthcare provider will want to make sure the antibiotics actually worked against your UTI. To do this, they may take another sample of your urine to see if the bacteria are still there or not. If the infection is cured, youll want to be sure there isnt a different issue thats causing similar symptoms.

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    Antibiotic Warnings And Treatment Concerns

    The most commonly prescribed antibiotics for uncomplicated UTIs are similar in efficacy. But its important to note that ampicillin, amoxicillin, and sulfonamides are no longer the drugs of choice for combatting UTIs because of the emergence of antibiotic resistance. In addition, amoxicillin and clavulanate has been shown in previous research to be significantly less effective than others when it comes to treating urinary tract infections.

    Also, as noted above, the FDA advises against using fluoroquinolones for uncomplicated UTIs. These medicines should only be considered if no other treatment options are available. In some cases, such as a complicated UTI or kidney infection, a healthcare provider may decide that a fluoroquinolone medicine is the best option, notes the American Academy of Family Physicians.

    For pregnant women, some common antibiotics, such as fluoroquinolones and tetracyclines, should not be prescribed because of possible toxic effects on the fetus. But oral nitrofurantoin and cephalexin are considered good antibiotic choices for pregnant women with asymptomatic bacteriuria and acute cystitis, according to past research.

    Treatment Of Bladder Urinary Tract Infections

    The specific intervention depends on the severity of the symptoms. In many instances, healthy patients who have a urinary tract infection but have no symptoms require no treatment at all. Such asymptomatic UTIs typically resolve within two to three days.

    If urinary tract infection symptoms are presentsuch as a burning sensation during urination or an increased need to urinatetreatment usually consists of antibiotic medications, which are prescribed for three to 14 days. They include:

    • Trimethoprim: Trimethoprim is the standard treatment for urinary tract infections in otherwise-healthy adults. It is one of the more potent UTI antibiotics, so most patients only require a three-day course. Trimethoprim is generally well-tolerated with few side effects, which generally include nausea, vomiting, diarrhea/constipation or stomach pain.
    • Nitrofurantoin: Nitrofurantoin is the second most commonly prescribed antibiotic for bladder UTIs. It usually requires a longer course than trimethroprim , and is usually well tolerated but should not be taken by anyone with kidney disease. Side effects include nausea and vomiting.
    • Cephalosporins: Cephalosporins are often used as a first-line of treatment in patients that have upper urinary tract infections involving the ureters or kidneys. It is usually taken for seven to 10 days. Side effects include nausea, vomiting, upset stomach and diarrhea.

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    What Is The Prognosis For A Urinary Tract Infection

    A good prognosis is usual for spontaneously resolved and quickly treated UTIs. Even patients that have rapidly developing symptoms and early pyelonephritis can have a good prognosis if quickly and adequately treated. The prognosis begins to decline if the UTI is not quickly recognized or treated. Elderly and immunosuppressed patients may not have the UTI recognized early their prognosis may range from fair to poor, depending on how much damage is done to the urinary tract or if complications like sepsis occur. Like adults, most adequately treated children will have a good prognosis. Children and adults with recurrent UTIs may develop complications and a worse prognosis recurrent UTIs may be a symptom of an underlying problem with the urinary tract structure. These patients should be referred to a specialist for further evaluation.

    Can A Urinary Tract Infection Be Prevented

    5 Phases to Heal UTIs Naturally (Without Drugs!)

    Many methods have been suggested to reduce or prevent UTIs. The single most important prevention measure is increased fluid intake. Many people develop UTIs simply because they do not drink enough fluids. Some of these are considered home remedies and have been discussed . There are other suggestions that may help prevent UTIs. Good hygiene for males and females is useful. For females, wiping from front to back helps keep pathogens that may reside or pass through the anal opening away from the urethra. For males, retracting the foreskin before urinating reduces the chance of urine lingering at the urethral opening and acting as a culture media for pathogens. Incomplete bladder emptying and resisting the normal urge to urinate can allow pathogens to survive and replicate easier in a non-flowing system. Some clinicians recommend washing before and urinating soon after sex to reduce the chance of urethritis and cystitis. Many clinicians suggest that anything that causes a person irritation in the genital area may encourage UTI development. Wearing underwear that is somewhat adsorptive may help wick away urine drops that otherwise may be areas for pathogen growth.

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    Can A Uti Go Away On Its Own

    While most patients with a UTI will be prescribed antibiotics, the truth is, uncomplicated urinary tract infections are often self-limiting, meaning they can potentially run their course sans antibiotic treatment, noted a 2018 report in PLoS Medicine.

    In fact, that same report found that more than one-half of the women studied experienced a UTI resolution without the use antibiotics. However, since kidney infections occurred in 7 out of 181 women using ibuprofen, the researchers concluded that, at this time, they cannot recommend ibuprofen alone as initial treatment to women with uncomplicated UTIs.

    A better idea, for now: Simply wait until a positive urine culture comes back before treating with antibiotics.

    Amoxicillin/potassium Clavulanate Cefdinir Or Cephalexin

    How it Works: is another combination drug that belongs to the penicillin class of antibiotics. and belong to a different class of antibiotics thats closely related to penicillins.

    All three antibiotics kill bacteria by destroying one of its most important components: the cell wall, which normally keeps bacteria structurally intact.

    Common doses:

    • Amoxicillin/clavulanate: 500 twice a day for 5 to 7 days

    • Cefdinir: 300 mg twice a day for 5 to 7 days

    • Cephalexin: 250 mg to 500 mg every 6 hours for 7 days

    Notable side effects: Diarrhea, nausea, vomiting, and rash are common side effects of these antibiotics. In rare cases, all three have the potential to cause the dangerous skin reactions, SJS and TEN.

    If you have a penicillin allergy, your healthcare provider wont prescribe amoxicillin/clavulanate. They may or may not prescribe cefdinir or cephalexin since there is a small chance that a person with a penicillin allergy may also be allergic to these two.

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    What If I Have Frequent Recurring Utis

    Within a year of havig a UTI infection, roughy one-quarter to one-half of women will have another UTI. For these women antibiotic prophylaxis may be recommended by her health care provider. With a recurrent course of UTIs, a urine culture or imaging tests may be required for further analysis.

    For recurrent UTIs, there are several antibiotic options for prevention:

    • A shorter course of antibiotics at the first sign of UTI symptoms a prescription may be given to you to keep at home.
    • A longer course of low-dose antibiotic therapy.
    • Take a single dose of an antibiotic after sexual intercourse.

    The choice of antibiotic is based on previous UTIs, effectiveness, and patient-specific factors such as allergies and cost. Antibiotics commonly used for recurrent UTIs can include sulfamethoxazole-trimethoprim, nitrofurantoin, cefaclor, or cephalexin.

    In postmenopausal women with vaginal dryness that may be leading to recurrent UTIs, vaginal estrogen may be an effective treatment. Treatment options your doctor might recommend include: Estring, Vagifem , or vaginal estrogen creams .

    Are Quinolones Safe

    Urinary Tract Infection In Women | Causes & Treatment

    The fluoroquinolones, such as ciprofloxacin and levofloxacin have also been commonly used for simple UTIs however, FDA safety recommendations strongly suggest that this class be reserved for more serious infections and only be used if other appropriate antibiotics are not an option.

    • An FDA safety review found that both oral and injectable fluoroquinolones are associated with serious and potentially disabling side effects involving tendons, muscles, joints, nerves and the central nervous system.
    • These adverse effects can occur soon after administration to weeks after exposure, and may potentially be permanent.
    • Patients should discuss the use of fluoroquinolones and their side effects with their healthcare provider.

    However, certain oral fluoroquinolones may be appropriate for more complicated UTIs, including pyelonephritis and complicated UTIs in men with prostate involvement. For the outpatient treatment of uncomplicated pyelonephritis, the following quinolones may be appropriate. Based on resistance patterns , an inital dose of a long-acting parenteral antimicrobial, such as ceftriaxone, may be needed, or a 24-hour dose of an aminoglycoside.

    Patients should be informed of the most current FDA warnings surrounding the use of fluoroquinolone antibiotics.

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    What Are The Risks

    Antibiotics can have side effects, such as fever, rash, diarrhea, nausea, vomiting, headache, tendon ruptures, and nerve damage.

    Antibiotics can cause future problems.

    Antibiotics can kill friendly germs in the body. This can lead to vaginal yeast infections. It can also lead to other infections, severe diarrhea, hospitalization, and even death.

    Also, antibiotics may help drug resistant bacteria grow. These bacteria are harder to kill. They cause illnesses that are harder to cure. Your health care provider may have to try several antibiotics. This increases the risk of complications. The resistant bacteria can also be passed on to others. If you get an infection from resistant bacteria, you may need more visits and medicines that cost more.

    When should older people take antibiotics for a UTI?

    If you have UTI symptoms, antibiotics can help.

    • The most common UTI symptom is a painful, burning feeling when you urinate.
    • Other UTI symptoms in older people may include fever, urge to urinate, and frequent urination. Along with these symptoms, there can be pain on one side of the back below the ribs or discomfort in the lower abdomen.

    Some kinds of surgery can cause bleeding in the urinary tractfor example, prostate surgery and some procedures to remove kidney stones or bladder tumors. If you are going to have this surgery, you may need testing and treatment for bacteria in urine.

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