Urinary Tract Infection - Medications

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Fluoroquinolones (Quinolones)

Fluoroquinolones (also simply called quinolones) are now becoming as widely used as TMP-SMX. They are the standard alternatives to TMP-SMX. Examples of quinolones include ofloxacin (Floxacin), ciprofloxacin (Cipro), norfloxacin (Noroxin), and levofloxacin (Levaquin). These drugs can have severe side effects, however, that the patient should discuss with the doctor.

Pregnant women should not take fluoroquinolone antibiotics. They also have more adverse effects in children than other antibiotics and should not be the first-line option in most pediatric situations.

Tetracyclines

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Tetracyclines include doxycycline, tetracycline, and minocycline. Treatment with tetracycline or doxycycline may be used for infections that are caused by Mycoplasma or Chlamydia. Tetracyclines have unique side effects among antibiotics, including skin reactions to sunlight, possible burning in the throat, and tooth discoloration. They cannot be taken by children or pregnant women.

Aminoglycosides

Aminoglycosides (gentamicin, tobramycin, amikacin) are given by injection for very serious bacterial infections. They can be given only in combination with other antibiotics. Gentamicin is the most commonly used aminoglycoside for severe UTIs. They can have very serious side effects, including damage to hearing, sense of balance, and kidneys.

Other Antibiotics Used Specifically for UTIs

Nitrofurantoin. Nitrofurantoin (Furadantin, Macrodantin) is an antibiotic that is used specifically for urinary tract infections as an alternative to TMP-SMX or a quinolone. Unlike many of the other drugs, however, it is usually taken for 7 - 10 days, even in cases of simple cystitis. It is not useful for treating kidney infections. Nitrofurantoin frequently causes stomach upset and interacts with many drugs. Other chronic or serious medical conditions may also affect its use. It should not be used in pregnant women within 1 - 2 weeks of delivery, in nursing mothers, or in those with kidney disease.

Fosfomycin. The antibiotic fosfomycin (Monurol) may be prescribed as a 1-dose treatment for women who are pregnant.