Medications for Urinary Tract Infection (UTI)

by Rosalyn Carson-DeWitt, MD

The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Only use each of these medicines as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

You may be prescribed antibiotics for 3 or more days. A 3-day course has been shown to be helpful for both younger and older women with urinary tract infections (UTIs), rather than taking the medicine for up to 10 days (or more). You should take the full course of medicine, even if you begin to feel better before all the medicine is gone.

In some cases, severe UTIs are treated with intravenous or intramuscular antibiotics. Researchers, though, have found that oral antibiotics appear to be as effective in treating UTIs as those given as injections.

If you are suspected of having a more serious infection, such as a kidney infection, you may need hospitalization, IV antibiotics, and fluids.

Prescription Medications

+ Beta-lactam antibiotics
  • Amoxicillin (Amoxil, Polymox, Trimox, Wymox)
  • Cefaclor (Ceclor)
  • Cefuroxime (Ceftin)
  • Cefpodoxime (Vantin)
  • Cefixime (Suprax)
  • Cefepime (Maxipime)
  • Piperacillin tazobactam (Zosyn)
+ Fluoroquinolone antibiotics
  • Ciprofloxacin (Cipro)
  • Levofloxacin (Levaquin)
  • Norfloxacin (Noroxin)
  • Ofloxacin (Floxacin)
+ Nitrofurantoin antibiotics
  • Furadantin
  • Macrodantin
+ Medicines for symptom relief
  • Phenazopyridine (eg, Basidium, Erodium, AZO Standard, Pyridium)
  • Combination medicine (eg, Prosed, Urised)

Beta-lactam Antibiotics

Common names include:

  • Amoxicillin (Amoxil, Polymox, Trimox, Wymox)
  • Cefaclor (Ceclor)
  • Cefuroxime (Ceftin)
  • Cefpodoxime (Vantin)
  • Cefixime (Suprax)
  • Cefepime (Maxipime)
  • Piperacillin tazobactam (Zosyn)

Possible side effects include:

  • Diarrhea —If diarrhea is severe, call your doctor.
  • Nausea, vomiting
  • Rash or allergic reaction
  • Bleeding problems—If you notice bruising, increased bleeding, or spontaneous bleeding, call your doctor.
  • May interfere with oral contraceptive pills—Use another form of contraception while you are taking these antibiotics.
  • May interfere with sugar levels in people with diabetes—Check with your doctor before you change your dose of insulin or other diabetes drugs.

Note: Some antibiotics should not be taken with alcohol. Check with your doctor.

Fluoroquinolone Antibiotics

Common names include:

  • Ciprofloxacin (Cipro)
  • Levofloxacin (Levaquin)
  • Norfloxacin (Noroxin)
  • Ofloxacin (Floxacin)

If you are taking antacids or sucralfate, do not take them within six hours of taking a fluoroquinolone. Take with a full glass of water. Take norfloxacin on an empty stomach. The others may be taken either on an empty stomach or with meals.

Possible side effects include:

  • May interact with antacids or sucralfate—Do not take these medicines within 2-6 hours of each other.
  • Increased sensitivity to sun
  • Dizziness, lightheadedness—Do not drive or participate in potentially hazardous activities until you know how these medicines will affect you.
  • Inflamed, torn tendons
  • Low blood sugar in people with diabetes
  • Irregular heartbeat (if you have low potassium in your blood)
  • For levofloxacin—Check with doctor before taking this drug if you are taking medicines for your heartbeat.
  • For enoxacin—Check with your doctor before taking this drug along with caffeinated products.

Trimethoprim-sulfamethoxazole Antibiotic

Common brand names include:

  • Bactrim
  • Cotrim
  • Septra

Trimethoprim-sulfamethoxazole is usually not prescribed for babies less than three months of age. Elderly people have an increased risk of skin and bleeding problems with these medicines, especially if they are already using diuretic medicines. Always take these drugs with a full glass of water.

Possible side effects include:

  • Bleeding problems (including increased bleeding, easy bruising, slow healing)—If possible, delay dental procedures.
  • Increased sensitivity to sun
  • Itching
  • Skin rash
  • Nausea, vomiting
  • Diarrhea
  • Stomach cramps
  • Dizziness, lightheadedness—Do not drive or participate in potentially hazardous activities until you know how these medicines will affect you.

Nitrofurantoin Antibiotics

Common brand names include:

  • Furadantin
  • Macrodantin

Take nitrofurantoin with food or milk in order to decrease the chance of stomach upset. Possible side effects include:

  • May interfere with sugar levels in people with diabetes—Check with your doctor before you change your dose of insulin or other diabetes drugs.
  • Diarrhea
  • Intestinal gas

Medicines for Symptom Relief

Phenazopyridine

Common brand names include:

  • Basidium
  • Erodium
  • AZO Standard
  • Pyridium

Phenazopyridine can help relieve the burning, urgency, and frequency of a UTI. You should stop taking this medicine when you are no longer having discomfort. It is usually advised not to take this medicine for longer than two days. Take with food to decrease the chance of stomach upset. Do not wear soft contact lenses while you are using this drug; it may permanently stain the lenses.

Possible side effects include:

  • Reddish-orange color to your urine and sweat
  • Headache
  • Stomach irritation

Call your doctor immediately if you are taking this drug and notice:

  • Shortness of breath
  • Confusion
  • Decreased urine
  • Blue color to your skin

Combination Medicine

Common brand names include:

  • Prosed
  • Urised

Prosed and Urised contain a combination of drugs to treat an infection, reduce bladder spasm, and relieve pain. These medicines should always be taken with a full glass of water.

Possible side effects include:

  • Dizziness, lightheadedness, sleepiness, blurred vision, changes in thinking—Do not drive or do hazardous activities until you know how these medicines will affect you.
  • Nausea or vomiting
  • Dry mouth
  • Change in color of urine or stool to blue or green

Call your doctor immediately if you are taking this drug and have:

  • Difficulty breathing
  • Severe dizziness
  • Severe diarrhea
  • Significant change in thinking clearly and logically
  • Unable to pass urine
  • Fast heartbeat
  • Sudden change in vision
  • Rash

Elderly people may have more side effects when taking Prosed or Urised.

Special Considerations

If you are taking medicines, follow these general guidelines:

  • Take your medicine as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Ask what results and side effects to expect. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medicine and herb or dietary supplements.
  • Plan ahead for refills so you do not run out.

References:

Acute cystitis in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated August 31, 2012. Accessed August 13, 2012.
Griffith’s 5-Minute Clinical Consult. Philadelphia, PA: Lippincott Williams & Wilkins; 2001.
Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine. EBSCO Health Library, Lexi-PALS website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated December 2009. Accessed September 11, 2012.
Urinary tract infections in adults. American Urological Association Foundation website. http://www.urologyhealth.org/urology/index.cfm?article=47 . Accessed September 11, 2012.
Urinary tract infections in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/ . Updated May 24, 2012. Accessed September 11, 2012.
12/5/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections [review]. Cochrane Database of Syst Rev. 2007(4).
9/3/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Lutters M, Vogt-Ferrier NB. Antibiotic duration for treating uncomplicated, symptomatic lower urinary tract infections in elderly women. Cochrane Database Syst Rev. 2008;CD001535.
Last reviewed September 2012 by Adrienne Carmack, MD
Last Updated: 9/26/2012
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