Antibiotics for UTI: What’re Your Options?

By Arielle Mitton
Medically reviewed checkmarkMedically reviewed
July 27, 2022

 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 UTIs often report experiencing relief within just a few days.

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

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 (as long as there is no resistance).

Fosfomycin (Monurol)

This medication works by blocking UTI-causing bacteria from sticking to the urinary tract’s lining. It is unique in that it is given as a single dose. 

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 (such as tendon rupture). Therefore, it is not a typical first-line choice for UTIs. 

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

Your primary care provider or a medical practitioner can help you decide which type of antibiotic is right for you.

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How Long to Take Antibiotics for a UTI

Very severe or complicated UTI cases may need up to 14 days of medication, but most patients with uncomplicated UTIs only require 3-7 days of treatment to fully eradicate their infection.

The exact number of doses needed depends on which antibiotic you are taking.

You should always make sure to take the full course of antibiotics that your healthcare provider prescribes to you to avoid antibiotic resistance in the future, even if symptoms improve before you’re done.

Over the Counter UTI Treatments 

There are a few over-the-counter (OTC) treatments available to soothe symptoms, though the Federal Drug Administration (FDA) has only approved antibiotics for treatment in UTIs.

There are also some at-home remedies and lifestyle changes you can make to make yourself more comfortable, or prevent future or recurrent UTIs. 

Your doctor may recommend phenazopyridine (Pyridium, Azo Urinary Pain Relief) for pain relief, which can numb pain in the urinary tract. Another common OTC pain-reliever for UTIs is Cystex.

Please note that these are not replacements for antibiotics, and only relieve pain while waiting for them to work or until you can get a prescription.

Phenazopyridine will turn your urine a bright orange color and you should only use it for up to 2 days in a row maximum.

At-home remedies

There are a number of things you can do at home to reduce your symptoms, as well as prevent future UTIs, including the following:

  • Cranberry products: It’s commonly thought that cranberry products can be taken to soothe the symptoms of a UTI. This is a myth. Once you have a UTI, cranberry products, including cranberry juice won’t do much to help your symptoms. However, research shows that drinking it will help decrease the number of UTIs you have, so it is useful in prevention
  • Loose-fitting clothing: Wearing loose fitting, breathable clothing — including cotton underwear — will make you feel more comfortable while you have a UTI. Being sure to change out of wet clothing will also help, and possibly prevent getting one in the first place.
  • Pee after sexual intercourse: Making sure to urinate after sexual intercourse is important, as it helps flush out bacteria before it has a chance to cause a urinary tract infection. 
  • D-Mannose: Research has shown that taking D-mannose has had a positive effect on easing symptoms of UTIs, as well as preventing future infections. 

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 or pyelonephritis. 

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, perhaps especially if your immune system is already compromised. 

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. 

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.

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When to See a Medical Provider

If you think you are experiencing symptoms of a UTI, don’t wait to see a doctor.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. Urine cultures can help doctors know which bacteria is in your urine 

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.

Arielle Mitton

Dr. Mitton is a board certified internal medicine physician with over 6 years of experience in urgent care and additional training in geriatric medicine. She completed her trainings at Mount Sinai Hospital and UCLA. She is on the board of the Hyperemesis Research Foundation to help women suffering from hyperemesis gravidarum.

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