What Are the Best Antibiotics for UTIs?

A urinary tract infection (UTI) is an infection of the urinary system. It is often associated with painful symptoms, which are typically treated with antibiotics. The best antibiotics for treating a UTI depend on the type of UTI and the severity of the symptoms. Nitrofurantoin, trimethoprim, and cephalexin are common antibiotics prescribed to treat UTIs. 

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Best Antibiotics for UTIs 

A UTI is a common infection of the urinary tract that can affect the kidneys, urethra, bladder, or ureters. They are often caused by bacteria entering the urinary tract, which then multiplies in the bladder. In addition, UTIs can also be caused by viral infections. Your doctor may request special testing if they believe you have a viral UTI, as they are treated with antivirals, not antibiotics. If you have a bacterial UTI, the best course of treatment would be antibiotics. 

Dr. David Beatty, a general practitioner for over 30 years, provided insight for this article. Dr. Beatty noted that in an ideal situation, a urine culture is performed to see the specific bacteria causing an infection. A physician can then determine the perfect antibiotic for killing the bacteria. In cases without urine cultures, which happens most often, the following is taken into consideration:

• Severity of illness
• Possibility of pregnancy
• Male or female
• If kidneys have been affected
• Previous antibiotic use

Best Antibiotics for UTIs

Antibiotics to Treat a UTI for Women 

When prescribing an antibiotic to a woman, your doctor will consider the UTI location. A UTI can be in the lower tract, which mainly affects the urethra and the bladder. According to Dr. Beatty, the first line of defense against a lower tract UTI would be nitrofurantoin. Trimethoprim is another option, although people have been developing resistance to this antibiotic. 

UTIs may also be in the upper tract, which tends to be more severe. They typically affect the kidneys, and if the bacterial infection spreads here, it could be life-threatening. Dr. Beatty suggests cephalexin or ciprofloxacin for an upper tract UTI. These drugs are usually reserved for these more serious infections since they likely cause thrush or a fungal infection in the mouth. If the condition becomes very severe, IV antibiotics may be used. 

Another factor that must be considered when prescribing a woman an antibiotic for her UTI is if she is pregnant. An upper tract UTI should also be treated with cephalexin. A lower tract UTI may be treated with nitrofurantoin, but not if a woman is close to the end of pregnancy, according to Dr. Beatty. A second option would also be cephalexin or amoxicillin. 

Antibiotics to Treat a UTI for Men

Although women are more susceptible to getting UTIs, men can also get them. These infections are often considered more serious than in a women’s case and should be treated as such. Men’s UTIs can also be in the lower or upper tract. An upper UTI in a man is also known as pyelonephritis and typically requires immediate intervention. This is where an intravenous (IV) antibiotic may be needed, says Dr. Beatty. A lower tract UTI in a man should be treated with nitrofurantoin or trimethoprim. 

Antibiotics to Treat a UTI for Children

Children are another group susceptible to UTIs. These infections in children are fairly common, but their symptoms may present differently than in adults. If you believe your child has a UTI, they need to see a doctor immediately. The UTI will not go away on its own. Dr. Beatty recommends a child should take nitrofurantoin or trimethoprim if they have a lower tract UTI. Those with an upper tract UTI should take cephalexin. 

Discussing Treatment for UTIs

If you believe you are experiencing any symptoms of a UTI, you should seek treatment immediately. You cannot receive a prescription for antibiotics without seeing a doctor or other health care provider. Waiting for the symptoms of a UTI to go away could cause the infection to spread, become more severe and potentially even enter the bloodstream. You may become more susceptible to getting a UTI if you have already had one before. 1 in 5 women is subject to recurrent UTIs, getting an infection at least three times a year. 

If you find yourself at urgent care or your primary care doctor looking for UTI treatment, there are some things you may want to consider asking your healthcare provider. You should write a list of questions ahead of time, so you don’t forget anything once you arrive. It's also important to write down the answers the doctor gives you to go over the information again once you leave. If you are confused about anything that is said, make sure to clarify. 

The following are some topics you may want to discuss with your doctor:

• Do I need to take antibiotics to treat my UTI?
• Past infections or past antibiotics taken - did they work? Did you have any adverse reactions?
• How much do antibiotics cost? Will insurance cover the cost?
• How did I contract a UTI? Can I do anything to keep it from happening again?
• Are there any self-care treatments I can do to relieve my pain and discomfort?
• How will I know if the infection is gone? Or progressing/getting worse?
• I’m pregnant. Do I need to worry about any potential complications for me or the baby?

Your doctor may also mention finishing the round of antibiotics that you are prescribed. It is extremely important to finish the entire prescription, even if you begin to feel better. If you stop taking antibiotics, it can increase the growth of bacteria resistant to drugs.

UTI Frequently Asked Questions (FAQs)

If you haven’t had a urinary tract infection before, you may have some questions. Below are the answers to some common questions about UTIs. 

What are the common symptoms of UTIs?

Symptoms and side effects of UTIs vary from person to person. Some may not experience symptoms at all, while others may have very severe side effects. Common side effects of UTIs include:

• Cloudy urine
• Strong smelling urine
• Pelvic pain
• Burning sensation when urinating
• Persistent urge to urinate
• Passing small amounts of urine

However, if the infection persists and turns into a more severe condition, symptoms may present differently. You should talk to a doctor if you experience any of the following:

• Vomiting
• Fever
• Chills
• Nausea

Are there at-home remedies for UTIs?

Antibiotics are the first line of defense for UTIs, especially if the infection is serious. There are no known over-the-counter treatments for UTIs or at-home remedies, but there are things you can do to ease your pain and discomfort and prevent future UTIs.

You should make sure to drink lots of water daily and urinate whenever you feel the urge to. Holding it in could lead to further complications. Cranberry juice and probiotics are great to keep in your system, as they can ward off harmful bacteria. 

How long can a UTI go untreated?

Some UTIs can go untreated, but any will rarely go away on their own. It is also extremely risky if you choose not to treat the infection. The best course of action is to see a doctor as soon as you can if you begin to experience symptoms. An untreated UTI could lead to more serious complications and potentially be life-threatening. 

What should I do if I think I have a UTI?

If you think you have a UTI, you should see a doctor immediately. Some pharmacies sell at-home testing strips; however, these are not as reliable as a doctor performing a diagnostic test. Once at the doctor, make sure to ask questions and explain your symptoms as best as possible. This will help the healthcare professional find the best medication for your treatment. 

What are the common causes of UTIs?

There are lots of everyday occurrences that can increase your chances of getting a UTI. These include:

• Sexual intercourse
• Birth control
• Menopause
• Pregnancy
• Antibiotics
• Use of tampons
• Poor personal hygiene
• Diabetes

It is important to speak with your healthcare provider to figure out what may be causing your UTIs so you can prevent them in the future. 

Are there side effects to antibiotics? 

Yes, like most drugs, there are potential side effects when taking antibiotics. Therefore, antibiotics should only be taken when necessary in order to avoid potentially harmful situations. Allergic reactions are the most common side effect that people experience. This could occur in a skin reaction, swelling, and even breathing problems. Sometimes, antibiotics can cause nausea or yeast infections. Although they kill bad bacteria, good bacteria can be killed as well, causing a yeast infection. 

Bottom Line

Urinary tract infections (UTIs) are a prevalent condition among men and women in the U.S. The most common course of treatment for UTIs is antibiotics. Finding the best antibiotic to treat a UTI depends on the severity of the UTI, one’s biological sex, and the location of the UTI. There are several options for treatment, but the most common are nitrofurantoin, trimethoprim, and cephalexin. 

If you think you have a UTI, you may consider going to urgent care for a diagnosis. The cost of going to urgent care and potentially being prescribed antibiotics can be expensive, especially if you are paying without insurance. A great way to reduce this cost is with Mira. For only $45 a month, Mira members get access to low-cost urgent care visits and up to 80% off over 1,000 different medications. Sign up today.