Antibiotics for UTI Treatment

Medically Reviewed by Jabeen Begum, MD on December 11, 2023
7 min read

A urinary tract infection (UTI), also called a bladder infection, starts when bacteria get into your bladder, kidneys, or another part of your urinary tract. The best way to treat a UTI – and to relieve symptoms like pain, burning, and an urgent need to pee – is with antibiotics.

These medications kill bacteria that cause the infection. It's important to take them just as your doctor prescribes. A minor UTI can turn into a serious kidney or blood infection if you don't.

Which antibiotic you get and how long you take it depends on your urine (pee) test results.

Your doctor will take a urine sample to confirm that you have a UTI. Then the lab will grow the germs in a dish for a couple of days to find out which type of bacteria you have. This is called a culture. It’ll tell your doctor what type of germs caused your infection. They’ll likely prescribe one of the following antibiotics to treat it before the culture comes back:

  • Ceftriaxone
  • Cephalexin
  • Doxycycline
  • Fosfomycin (Monurol)
  • Nitrofurantoin (Macrobid, Macrodantin, Furadantin)
  • Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS)

When your doctor gets the results of the culture, they may switch the antibiotic to one that is made specifically to fight the bacteria causing your UTI. 

Complicated vs. uncomplicated UTI

Which medication and dose you get also depends on whether your infection is complicated or uncomplicated. 

Uncomplicated means your urinary tract is normal and you are otherwise healthy. This makes your UTI easier to treat. 

Complicated means there is another condition that makes your UTI harder to treat. 

You might have a complicated UTI if you're pregnant or if you have:

  • Recurring UTIs that can't be controlled with the typical antibiotics
  • Problems with kidney function
  • A weakened immune system due to HIV, steroid use, or another cause
  • A problem with your urinary tract, such as a narrowing of your ureters, which are the tubes that carry urine from your kidneys to your bladder

To treat a complicated infection, your doctor might prescribe different antibiotics, and you may have to take them for a longer time. If your UTI is severe or the infection is in your kidneys, you might need to be treated in a hospital or doctor's office with antibiotics you get through an IV.

Doxycycline for UTI

Doxycycline is an antibiotic sometimes used as a UTI treatment. It works by killing the bacteria that cause the infection and controlling their growth.

This medicine comes with several precautions. It may 

  • Darken the color of your skin, nails, eyes, teeth, gums, or scars
  • Cause diarrhea
  • Interfere with your birth control pills 
  • Cause your skin to be much more sensitive to light 

Cephalexin for UTI

Cephalexin can kill bacteria that cause UTIs and prevent their growth. This drug may cause diarrhea.

Augmentin for UTI

Augmentin is a combination of two antibiotics – amoxicillin and clavulanate. It isn’t a first choice for UTI treatment, but it can help you when other preferred antibiotics haven’t. Possible side effects include diarrhea, rash, vomiting, headache, and lack of appetite. 

Antibiotics for UTI over the counter

You can’t get oral antibiotics over the counter in the U.S. Antibiotics don’t all work the same way, and you need to see your doctor to find out which one you should use. Antibiotics can also have serious side effects, so it’s important that you only take them under your doctor’s supervision.

Best antibiotic for UTI in elderly 

Common antibiotics used to treat UTIs might not work as well in older people. They are at higher risk of having drug-resistant infections, which means it's harder or even impossible for antibiotics to cure the infection. This is especially common for people in nursing homes and hospitals.

For uncomplicated UTIs that are easier to treat, a narrow-spectrum antibiotic like trimethoprim may help. Narrow-spectrum means it's only able to kill certain types of bacteria. Complicated UTIs are more often treated with broad-spectrum antibiotics that can kill many bacteria types.

It's important for older people to be treated quickly with antibiotics. Research shows that not getting antibiotics or waiting to take them can increase the risk of blood infections and death.             

UTIs are one of the most common complications when you’re pregnant. The physical changes your urinary tract goes through during pregnancy can increase the risks of bacterial growth and UTIs. This can cause a more serious infection for you or your unborn baby. You should report any symptoms to your doctor. 

Antibiotic for UTI in pregnancy

Your doctor may prescribe nitrofurantoin (Macrobid, Macrodantin). It works to fight many types of bacteria that are common during pregnancy.

If you’re pregnant, you should not take fluoroquinolone antibiotics. They may harm your baby in the womb.

If you don’t get treatment, your UTI could lead to: 

  • Kidney infection 
  • Premature birth
  • Low birth weight
  • High blood pressure
  • Preeclampsia 

Your doctor will let you know how long to take your UTI medicine. Typically, for an uncomplicated infection, you'll take antibiotics for 2 to 3 days. Some people will need to take these medicines for 7 to 10 days. For a complicated infection, you might need to take antibiotics for 14 days or more.

If you still have symptoms after you finish your antibiotics, your doctor may do another urine test to see whether the bacteria are gone. If you still have an infection, you'll need to take antibiotics for a longer period of time.

If you get recurrent UTI infections, you may need a prolonged course of antibiotics. And if sex causes your UTIs, your doctor may have you take a dose of the medicine right before you have sex.  

Why should I take the full dose?

Antibiotics work well against UTIs. You might start to feel better after being on the medicine for just a couple of days. But it's important to keep taking your medicine. If you stop your antibiotics too soon, you won’t kill all the bacteria in your urinary tract. It can start to grow again and your infection can get worse.

Like any medicine, antibiotics may have side effects such as:

  • Rash
  • Dizziness
  • Diarrhea
  • Nausea, vomiting
  • Headache
  • Yeast infections

There are other more serious, but uncommon, effects that can happen, such as an infection with a bacteria called Clostridioides difficile. This can cause diarrhea and severe colon damage – and even death. Also, if you are allergic to antibiotics, you could have a severe or life-threatening reaction. 

Antibiotic resistance

The germs in UTI infections can become resistant to antibiotics over time. That means the medicines will no longer kill these bugs in the future. So if you get another UTI, the medication you take might not treat it.

You should always see your doctor when you have a UTI. But there are some things you can do at home that may help relieve symptoms and prevent future infections. These home remedies aren't proven to cure an infection, so you shouldn't use them in place of medical treatment.

Baking soda for a UTI         

Baking soda, or sodium bicarbonate, might help reduce the acidity of your pee and treat some of the symptoms of a mild UTI. Drinking a glass of water with 1 teaspoon of baking soda dissolved in it every 3 or 4 hours may help. But you shouldn't do this without talking to your doctor first. Some people who need to control their salt intake shouldn't try this because baking soda is very high in sodium. 

Apple cider vinegar for a UTI

Some of the enzymes in ACV may help prevent bacteria from multiplying. You can also drink this mixed with water. Ask your doctor how much and how often you should drink it. Drinking too much apple cider vinegar can have negative effects, such as tooth erosion.

Supplements for a UTI

Some supplements that could help treat and prevent UTIs along with medical care include:

  • Vitamin C
  • Probiotics (good bacteria)
  • D-mannose, a type of sugar 
  • Methenamine salts 
  • Cranberry products

Your doctor may run more tests if you get two UTIs in 6 months or three or more within a year. That means you have recurrent UTIs. 

You may need to take a small dose of antibiotics every day. Your doctor might also tell you to take a small amount of antibiotic before or after you have sex, or when you start to notice symptoms of an infection.

Your body’s immune system can sometimes clear a UTI without any treatment. But more of then than not, these infections do not go away without antibiotics.

Getting treatment for your UTI quickly can prevent the infection from spreading to other parts of your urinary tract. If you ignore UTI symptoms, the infection can spread to your bladder and to your kidneys, where it can be much harder to treat. It's rare, but the infection can also get into your bloodstream. 

Your UTI symptoms should improve in a few days with treatment. Call your doctor if:

  • Your symptoms don't go away
  • Your symptoms get worse
  • Your symptoms come back after you've been treated
  • You have bothersome side effects from your antibiotics
  • You have a fever
  • You develop back pain
  • You are vomiting