What You Need To Know About Antibiotics And UTIs
When you get a urinary tract infection, what do you do? Many of us call for the desperate “Get me in right this second; her other patients can wait” sort of doctor’s appointment. That way we can get those magical little pills that take away the pain: antibiotics
Why are antibiotics the go-to treatment of UTIs? Could they be causing more harm than good? Are there any better solutions?
I want to dive with you into the idea of antibiotic treatment for UTIs. You will see they are often a doctor’s first line of defense. But by the time we are done, you should have the tools to decide whether or not they should be yours.
Let’s start with an overview of the two ways antibiotics are prescribed for urinary tract infections: one-time treatments and chronic infection prevention.
Antibiotics: The Go-To UTI Treatment
Most UTIs stem from the E. coli bacteria. (This is important fact for later, so save it in your memory bank). Since we are talking about infections and bacteria, antibiotics may seem like the obvious treatment for these painful episodes.
And that is exactly what doctors are prescribing. When you go to the doctor and they confirm your pain and urgency is related to a UTI, you get antibiotics.
According to the Mayo Clinic, the most common antibiotics prescribed for UTIs are:
- Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
- Fosfomycin (Monurol)
- Nitrofurantoin (Macrodantin, Macrobid)
- Ciprofloxacin (Cipro)
- Levofloxacin (Levaquin)
- Cephalexin (Keflex)
- Ceftriaxone (Rocephin)
- Azithromycin (Zithromax, Zmax)
- Doxycycline (Monodox, Vibramycin, others)
For the most part, antibiotics have been the most effective UTI treatment by knocking out that bacterial infection pronto. Normally, you begin feeling better within 24 to 48 hours.
And when you are talking about the pain and discomfort of a UTI – the quick turnaround is a welcome relief.
Antibiotics: The Go-To UTI Preventer
Any of us who have had one or two UTIs can only imagine the agony of chronic urinary tract infections. For those who suffer from frequent UTIs, a regimen of these antibiotics is normally prescribed for preventative reasons.
UTIs are no laughing matter; women want relief. But staying on continual antibiotics isn’t a joke either. A whole slew of side effects can pop up when you stay on antibiotics long term:
- Stomach upset
- Yeast infections (and yeast imbalance in general)
The antibiotics used in this way act like a “Band-Aid” covering up the symptoms, as “studies show that this kind of treatment is short-acting.”
This means you stop the antibiotic and probably wind up with yet one more UTI. But what’s a woman to do?
The Ever-Growing Problem Of Antibiotics And UTIs
Outside of the frustrating prospect of needing to take one antibiotic after the other simply to avoid another infection - there are some other real downsides in the world of antibiotics and UTIs.
As doctors have prescribed more and more antibiotics to help their suffering patients, bodies started developing resistance toward the antibiotics and their effectiveness.
I know it’s sometimes helpful for me to see science in action instead of just read about it. So here is a fascinating video about the quick process of evolving antibiotic resistance.
This over-prescribing of antibiotics is by no means only attached to UTIs. But it is worsened by the bacterium most common in UTIs – and here it is again – E. coli.
E. coli is listed as one of the “especially troubling” examples of resistant strains of bacteria when it comes to this rampant antibiotic resistance.
In other words, UTIs are becoming less and less treatable with their #1 source of treatment. Antibiotics simply are not working the way the used to work.
So what do doctors do? WebMD reports some of their current solutions, none of them being ideal alternatives:
- Resort to older antibiotics, not as effective for combatting UTIs
- Introduce a catheter into a patient’s arm to offer IV antibiotics
- Ask the FDA if they can use drugs not yet approved
But Wait… There’s More…
I’d like to say that’s the only troubling news, but it continues.
Fluoroquinolones, a class of antibiotics most frequently used to treat UTIs, have recently been given a new Boxed Warning to alert patients of some serious safety issues.
This warning discusses the “disabling and potentially permanent side effects of the tendons, muscles, joints, nerves, and central nervous system that can occur together in the same patient.”
Included in this warning are the the following currently-available fluoroquinolones:
- Avelox (moxifloxacin)
- Cipro (ciprofloxacin)
- Cipro extended-release (ciprofloxacin extended-release)
- Factive (gemifloxacin)
- Levaquin (levofloxacin)
- Ofloxacin (generic brand)
So not only are antibiotics becoming less effective at treating E. coli in general, but also some of the top antibiotics for treating your UTI now have massive warnings for causing disabling side effects.
So Are Antibiotics The Only Solution?
There have to be other ways, right? What about “waiting it out”?
An extremely small Dutch study found 51 women willing to “delay” antibiotic treatment of their urinary tract infections. In 71% of these women, the UTI either went away or improved – even without the antibiotic treatment.
Many medical professionals believe this sampling is far too small to consider the study a prime example of leaving behind the antibiotics for good. One interviewed New York City gynecologist, Dr. Jennifer Leighdon Wu, said cautiously, "Before changing my practice, I would like to see much larger numbers."
Plus - a 2004 study showed that only 7% of women hoping the infection would go away on its own actually had symptoms disappear.
So outside of simply seeing if it will go away on its own (while you are doubled over in pain, by the way!), here are some other viable solutions worth exploring:
And no matter who you are, prevention is the key to avoiding the antibiotic dilemma altogether. Tips include:
- Drinking plenty of water
- Urinating regularly (especially immediately after sexual intercourse)
- Wiping from front to back to avoid the spread of bacteria
- Avoid cleansing feminine products (like douches)
- Switch to cotton underwear
- Use birth control methods other than spermicidal jelly or condoms with spermicide as they can aid in the colonization of bacteria
UTIs, Antibiotics, And You: What Should You Do?
I’m sure you’re wondering how seriously you take the issues with antibiotics and UTIs. Your answer probably depends on what is actually going on in your body.
If you rarely – or never – get a UTI, but find yourself with a one-time affliction, a single round of antibiotics should get the job done without building up resistance.
But for anybody who has had multiple UTIs – or even suffers from chronic UTIs – the idea of finding solutions outside of antibiotics is worth investigating.