Treatment

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Urinary tract infections are treated with medications that kill the bacteria causing the infection. Your health care professional will determine which medication to prescribe and how you should take it, based on your medical history and condition and the results of the urine tests. Many medications can have side effects, so talk to your health care professional about what to expect. Also, medications can interact with other prescriptions and over-the-counter drugs, so make sure you tell your health care professional what drugs you are taking.

The antibiotics most often used to treat urinary tract infection are pills typically taken for three days, and more complicated infections are usually treated with seven to 10 days or more of antibiotics, sometimes more, depending on the bacteria causing the infection, the drug used and your medical history. These drugs include:

• amoxicillin (Amoxil, Trimox, Wymox)

• ciprofloxacin (Cipro)

• gatifloxacin (Tequin)

• levofloxacin (Levaquin)

• nitrofurantoin (Macrobid, Furadantin)

• norfloxacin (Noroxin)

• ofloxacin (Floxin)

• trimethoprim (Trimpex)

• trimethoprim/sulfamethoxazole (Bactrim, Septra, Cotrim)

Note: The U.S. Food and Drug Administration has just issued a black box warning on fluoroquinolones, which include the antibiotics ciprofloxacin, gatifloxacin, levofloxacin, norfloxacin, and ofloxacin, because of an increased risk of tendonitis and tendon rupture with use of these medications.

Urinary tract infections caused by microorganisms, such as chlamydia, may be treated with the antibiotics azithromycin, tetracycline or doxycycline.

Although your symptoms may be relieved in a day or two after starting the medication, you must take all the medication your health care professional prescribes. Otherwise, you run the risk of a recurrence. That is, some bacteria may survive and cause your infection to return or cause reinfection with a new or different organism.

If you are menopausal, you may experience more frequent urinary tract infections because thinning of the tissues of the vagina and urethra following menopause may make these areas less resistant to bacteria. Hormone replacement (either systemic or vaginal) may help. Vaginal estrogen has fewer health risks than systemic estrogen (such as in birth control pill and patches) because only a small amount is absorbed into the bloodstream. Vaginal estrogen is available as a cream (Premarin, Estrace), a tablet (Vagifem) and a flexible plastic ring (Estring). Femring is another vaginal estrogen product, but it has higher doses of estrogen and is primarily recommended for hot flashes; women with a uterus who use Femring should take progestin to minimize their risk of uterine cancer.

Discuss these treatment options and the latest research about their risks and benefits with your health care professional, keeping your personal health history and needs in mind. If you decide to take hormone replacement therapy, you should take the lowest dose that helps for the shortest time possible. You and your doctor should also reevaluate every six months whether or not you should be taking hormones.

Severe kidney infections may require hospitalization and treatment with intravenous antibiotics, especially if nausea, vomiting and fever increase the risk of dehydration and prevent the ability to swallow pills. Kidney infections usually require two weeks of antibiotic therapy, although treatment may extend as long as six weeks (this extended course usually is prescribed for men whose infections are due to prostatitis, however).

In addition to taking your medication, your health care professional may recommend drinking plenty of fluid (the equivalent of six to eight 8-ounce glasses a day) to help flush the urinary tract and avoiding foods and beverages that can irritate the urinary tract, such as coffee and alcohol. A heating pad may also help to temporarily relieve pain.

After you've completed your course of medication, your health care professional may suggest a follow-up urine test to make sure the infection is gone.