Antibiotics for UTI: What’re Your Options?

By Irmanie Hemphill, MD, FAAFP
Medically reviewed
February 17, 2021

If you are experiencing a urinary tract infection (UTI), you are not alone. Roughly 60% of women and 12% of men will have at least one UTI in their lifetimes. It is one of the most common outpatient infections in the United States. 

Urinary tract infections begin when microbes enter the urinary system, overcome the body’s natural defense mechanisms, and multiply. For many patients, these infections can be uncomfortable. 

Although fungi or viruses can cause some UTIs, bacterial microbes are the primary cause behind most infections. The best way to treat a bacterial UTI is to kill the germs causing the condition with antibiotics. Patients who take antibiotics for UTI conditions often report experiencing relief within just a few days.

Let’s take a closer look at the different antibiotic options for UTI treatment.

What Is a Urinary Tract Infection?

A urinary tract infection is an unpleasant but common condition that affects all or part of your urinary system.

UTIs can affect the lower urinary tract (your bladder and urethra), your upper urinary tract (including your kidneys and ureters) or both.

Lower urinary tract infections are sometimes called bladder infections. Upper urinary tract infections are also called kidney infections

Normally, your urinary tract makes, stores, and ultimately evacuates urine, a waste product, from your body. This occurs in a few simple steps:

  • Kidneys filter liquid waste from your blood to create urine.
  • The urine then travels through two tubes called the ureters and into your bladder.
  • Your bladder expands to store urine until you urinate.
  • Eventually, the bladder evacuates the liquid through your urethra and out of your body. 

Urine is sterile. It contains fluids, salts, and other waste products but no microbes. Under normal circumstances, it flows down and out, which helps push away any microbial invaders from gaining access to your internal organs.

Occasionally though, your defense mechanisms can fail. When that happens and microbes–typically bacteria from your anus or skin–enter the urethra and migrate upwards into your body, they can cause inflammation, irritation, and discomfort. When the microbes become established and begin to multiply, you have developed a urinary tract infection. 

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Types of UTIs

There are two types of urinary tract infections: uncomplicated and complicated. 

  • An infection is considered an uncomplicated UTI when a patient has no history of underlying health issues or urinary tract abnormalities. 
  • When a patient has an anatomical abnormality or condition that obstructs the urinary tract, like an enlarged prostate, kidney stones, or a medical device, the UTI is considered complicated.

Doctors treat both uncomplicated urinary tract infections and complicated ones with antibiotics, but they may prescribe a stronger or longer medication course for complicated cases.

Men and women can develop UTIs, but women are much more likely to experience one at least once in their lifetime. That’s because women’s urethras are shorter and closer to their anus than men, which means that bacteria can more easily migrate into their urinary system.

When men develop UTIs, healthcare professionals are likely to consider their infections to be complicated and require more extensive treatment plans.

Symptoms and Causes 

Escherichia coli (E. coli), a bacteria that normally lives in the intestines, causes approximately 85% of UTIs in women. 

Bacteria like Staphylococcus, chlamydia, and gonorrhea can also cause UTIs. Occasionally, fungi, and even more rarely, viruses are behind a urinary tract infection.

Doctors will only prescribe UTI antibiotics to patients who are battling a bacterial infection. The medication will not work on patients that have a fungal or viral condition. 

When microbes enter the urinary system, they irritate and inflame the organs’ lining, which can feel uncomfortable or painful. People with UTIs may experience symptoms like: 

  • An intense or persistent urge to urinate, even after using the restroom 
  • A burning or painful sensation during urination 
  • Difficulty urinating or a loss of bladder control  
  • Strong-smelling or cloudy urine
  • Bloody urine
  • Urethral discharge
  • Pelvic pressure or abdominal pain
  • Back pain
  • Nausea and vomiting
  • Fever or chills

Sometimes UTIs can be asymptomatic, meaning that patients have microbes in their urinary tract but do not experience any symptoms.

Treatment Options 

Doctors usually suggest antibiotics for UTI treatment, and this is for good reason. While urinary tract infections can sometimes resolve themselves without treatment, and you may be able to manage some symptoms with natural remedies, it is likely not worth the risk of going untreated and developing more serious health issues.

Antibiotics are safe, antimicrobial medications that stamp out a bacterial urinary tract infection by killing or blocking the germs that cause it. Specific prescriptions will depend on your general health, the nature of your infection, and the type of bacteria found in your urinary tract. 

No matter what kind of antibiotic you take, it’s important that you finish the full course of antibiotics, even after you begin to feel better. If you do not take all of your antibiotics, you may not eradicate all of the bacteria in your body. The germs could develop an antibiotic resistance and lead to recurrent UTI symptoms.

Antibiotics for UTI 

If you are looking for the best antibiotic for treating a UTI, the answer will largely depend on the type of bacterial infection that you have.

Several antibiotics can treat a UTI, but your doctor will prescribe the one most appropriate for your overall health, the complicated or uncomplicated nature of your infection, and the type of bacteria found in your urinary tract. 

Some antibiotics that doctors prefer to prescribe for UTIs include: 

  • Trimethoprim-sulfamethoxazole (Bactrim, Septra): This medication combines two antibiotics that work together to treat infections by interrupting the processes bacteria need to survive. 
  • Amoxicillin-potassium clavulanate (Augmentin): This antibiotic is used for various infections, including urinary tract infections, and works by stopping the growth of bacteria. 
  • Nitrofurantoin (Macrodantin, Macrobid): This antibacterial agent works well in urine and is used to treat urinary tract infections caused by E. Coli, Enterobacter cystitis, Enterococcus, Klebsiella, and Staphylococcus, specifically.
  • Fosfomycin (Monurol): This medication works by blocking UTI-causing bacteria from sticking to the urinary tract’s lining. Doctors use it to treat patients who might be suffering from an antibiotic-resistant strain of bacteria. 
  • Cephalexin (Keflex): Doctors use this antibiotic to stop bacterial growth and treat various bacterial infections, including UTIs. 
  • Ciprofloxacin (Cipro): This medication blocks bacteria from multiplying. It can be successfully used to treat urinary tract infections but comes with a higher risk of side effects. 

You cannot buy over-the-counter antibiotics in the United States. They are only available by prescription

Your doctor can help you decide which type of antibiotic is right for you.

Very severe or complicated UTI cases may call for up to 14 days of medication, but most patients only require 3-7 days of treatment to full eradicate their infection. 

Complications and Side Effects

Antibiotics can cause side effects. Depending on which medication your doctor prescribes for your UTI, the side effects may include: 

  • Nausea
  • Loss of appetite
  • Vomiting
  • Diarrhea 
  • Bloating  
  • Indigestion
  • Abdominal discomfort or pain

Some people can be allergic to certain antibiotics. If you develop hives, a rash, or other skin changes after beginning your medication, you may be sensitive to your prescription and should seek medical advice. 

If you begin to cough or wheeze, feel lightheaded, a fast heartbeat or clammy skin, feel confused, a tightness in your throat, or have difficulty breathing, you may be experiencing a medical emergency called anaphylaxis. Call your doctor or go to the emergency room immediately.

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When to See a Doctor

If you think you are experiencing symptoms of a UTI, don’t wait to see a doctor. Some UTIs can go away on their own, but most likely you’ll need an antibiotic prescription to treat the infection.

Your doctor might ask you to provide a urine culture (urine sample) to help determine whether you are suffering from a UTI. If so, they can prescribe antibiotics to help you feel better in just a few days.

If you are suffering from recurrent urinary tract infections, consider contacting a urologist to assess your urinary tract.

How K Health Can Help

Did you know you can get affordable UTI treatment with the K Health app? Download K to check your symptoms using our AI-driven symptom checker and, if needed, text with a doctor in minutes. K Health’s board-certified, U.S.-based doctors can provide a treatment plan and, if required, a prescription to resolve your symptoms as soon as possible.

Frequently Asked Questions

What is the strongest antibiotic for a UTI?
There isn’t a single antibiotic that is stronger than any other. Different antibiotics work against different bacteria strains; some may be better or more effective at treating some infections but be less likely to help with others. Your doctor will suggest the antibiotic that they believe is right for you.
Which antibiotics are best for UTI?
The best antibiotic to treat your UTI will depend on the nature of your infection, the type of bacteria in your urinary tract, and your overall health, including drug sensitivities and other prescriptions. Your doctor will weigh all of these factors when suggesting the correct antibiotic for you to take.
How long does it take for a UTI to go away without antibiotics?
While some UTIs will resolve on their own without medication, many do not. If left untreated, some UTIs can spread to the kidneys and into your blood, damaging your organs and leading to life-threatening health complications like sepsis. Antibiotics are a safe and effective treatment to stop urinary tract infections before they develop into anything worse.
What bacteria causes a UTI?
Several bacteria cause urinary tract infections. Escherichia coli (E. coli) is responsible for 85% of cases among women, but Staphylococcus saprophyticus, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, Chlamydia, and Gonorrhea, can cause urinary tract infections as well.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Irmanie Hemphill, MD, FAAFP

Dr. Hemphill is an award winning primary care physician with an MD from Florida State University College of Medicine. She completed her residency at Halifax Medical Center.