Antibiotics commonly used to treat urinary tract infections (UTIs) include nitrofurantoin (Macrobid, Macrodantin), fosfomycin (Monurol), and sulfamethoxazole-trimethoprim (Bactrim). These are usually the first-line choices for uncomplicated UTIs. If these cannot be used, alternatives may include amoxicillin/clavulanate (Augmentin) and certain cephalosporins such as cephalexin or cefdinir. Newer antibiotics recently approved include Pivya (pivmecillinam), Orlynvah (sulopenem etzadroxil and probenecid), and Blujepa (gepotidacin) for uncomplicated UTIs, especially in adult females. For complicated UTIs, intravenous options like Exblifep (cefepime and enmetazobactam), Fetroja (cefiderocol), and Vabomere (meropenem and vaborbactam) may be used. The choice of antibiotic depends on factors like infection type (complicated vs uncomplicated), patient history, safety, local resistance patterns, and cost. Often a urine culture guides specific antibiotic selection. Summary of antibiotics for UTI:
- First-line (uncomplicated UTI): Nitrofurantoin, fosfomycin, sulfamethoxazole-trimethoprim
- Alternatives: Amoxicillin/clavulanate, cephalosporins (cephalexin, cefdinir)
- New oral antibiotics: Pivya, Orlynvah, Blujepa
- Complicated UTI (IV antibiotics): Exblifep, Fetroja, Vabomere
Usually, antibiotic treatment lasts days to a week depending on the infection and medication, with symptoms improving within a few days after starting therapy.
