Medical Health Encyclopedia Fosfomycin. The antibiotic fosfomycin (Monurol), which comes in an orange-flavored, soluble powder, is proving to be another good alternative. It can be an effective one-dose treatment for many women, including those who are pregnant. To date, bacterial resistance rates to this antibiotic are very low. Tetracyclines Tetracyclines inhibit bacterial growth. They include doxycycline, tetracycline, and minocycline. Long-term 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. Text Continues Below Aminoglycosides Aminoglycosides (gentamicin, kanamycin, 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 serious UTIs. They can have very serious side effects, including damage to hearing, sense of balance, and kidneys.

Treatment for Uncomplicated UTIs

Studies are now reporting that uncomplicated UTIs in low-risk women can often be successfully treated over the phone. In such cases, a health professional, usually a nurse, provides the patients with three-day antibiotic regimens without even requiring an office urine test. This course is now recommended only for women at low risk for recurrent infection and who do not have symptoms suggesting other problems, such as vaginitis. In some centers, women who are treated over the phone have to be less than 55 years old; all other patients need to see a doctor for evaluation.

Antibiotic Regimen. Oral antibiotic treatment cures 94% of uncomplicated urinary tract infections, although the rate of recurrence remains high. The following are antibiotics used for uncomplicated UTIs.

• The standard regimen is a three-day course of trimethoprim-sulfamethoxazole, commonly called TMP-SMX (Bactrim, Cotrim, Septra). A single oral dose of TMP-SMX is sometimes prescribed in mild cases, but cure rates are generally lower (87%) than with the three-day regimens. (Longer-term therapy, given for seven to 10 days, is now mostly limited to men, children, the elderly, people with diabetes with any UTI, and women with pyelonephritis or who are pregnant.)
• An antibiotic called a fluoroquinolone, such as ciprofloxacin (Cipro), is usually the second choice. In fact, it is often the first choice where there are the high rates of bacterial resistant to TMP-SMX. Fluoroquinolones can also be given in a three-day course. Pregnant women should not take these drugs.
• Nitrofurantoin (Furadantin, Macrodantin) is a third option. This drug must be given for longer than three days.
• Fosfomycin (Monurol) is not as effective as other antibiotics but may be used during pregnancy. Resistance rates to this drug are also very low.