The drugs available to treat UTIs today are extremely effective. However, because not all medications work equally well against all bacteria or for all women, you and your doctor may have to experiment, especially if you have recurring infections.
Drug Therapy
Eighty percent of the time, cystitis can be cured with a single dose of trimethoprim (Trimpex) or 3 to 5 days of trimethoprim/sulfamethoxazole (Bactrim, Septra, others) or sulfisoxazole (Gantanol, others). If you are allergic to sulfa drugs, you may be given one of the quinolone antibiotics such as ciprofloxacin (Cipro), gatifloxacin (Tequin), norfloxacin (Noroxin), ofloxacin (Floxin), enoxacin (Penetrex), or lomefloxacin (Maxaquin). Sulfa drugs should not be taken during the last 4 weeks of pregnancy because they can cause jaundice in the newborn. Other popular antibiotics are cephalexin (Keflex), cefixime (Suprax), and cefuroxime (Ceftin, Kefurox, Zinacef).
The short-term therapy that is commonly used today is far better than the former standard of 7 to 14 days of antibiotics. That regimen was somewhat self-defeating, since vaginal yeast infections are one side effect of long-term antibiotic therapy and yeast infections can trigger UTIs! Other side effects included diarrhea and allergic reactions.
Treatment will be longer and require different or additional drugs if the urine culture shows tougher bacteria than E. coli, such as Staphylococcus, Chlamydia, or Mycoplasma. More than one kind of bacterium may be present; if so, they must all be eradicated.
Some doctors prefer to prescribe other drugs. Amoxicillin (Amoxil, Trimox, Wymox) and ampicillin (Principen) are less effective for some women, but might work well for you. Nitrofurantoin (Macrodantin) and cephalosporin antibiotics such as Ancef and Kefzol can be used as well.
To relieve pain almost immediately, you may also be given a prescription for an antispasmodic, such as hyoscyamine (Cystospaz) or flavoxate (Urispas). These drugs relax the bladder muscle, reducing the constant urge to urinate. Also commonly prescribed is a local anesthetic, phenazopyridine hydrochloride (Pyridium).
Be sure to do your part to make your treatment work. Finish all prescribed antibiotics. Even though your symptoms will probably stop within hours, some bacteria may survive if you don't take the full course of treatment. To replace the "friendly" bacteria that die off at the same time, many doctors now recommend adding yogurt or an acidophilus supplement to your diet. Your doctor may ask you to make an appointment to return for a repeat urine culture in a week or twoand keep the appointment even if you feel fine. Remember that UTIs can come back quickly and with a vengeance.
Hospitalization
Urinary tract infections rarely send anyone to the hospital. Hospitalization is necessary for surgery to correct certain physical conditions, such as a large cystocele protruding into the vaginal wall. If a kidney infection develops, hospitalization is often required to supply strong drugs or pain relief through an IV line. Since the nausea and vomiting that frequently accompany a kidney infection can lead to dehydration, an IV line can also supply fluids to prevent that from happening.
