Antibiotics For UTI Treatment: What Are My Options?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on July 29, 2021.

What is a UTI | Which antibiotic to use | Common side effects | Antibiotic resistance | New antibiotics | OTC antibiotics | Recurring UTIs | Treatment without antibiotics | Cranberry juice | More resources

What is a urinary tract infection (UTI)?

If you have ever experienced the frequent urge to go the bathroom with painful and burning urination, you have probably experienced a urinary tract infection (UTI). UTIs are one of the most common types of infections, accounting for over 10 million visits to health care providers each year. Roughly 40% of women experience a UTI at some time, and in women, it is the most common infection. Healthcare costs related to UTIs exceed $1.6 billion per year.

A urinary tract infection (UTI) can happen anywhere along your urinary tract, which includes the kidneys (the organ that filters the blood to make urine), the ureters (the tubes that take urine from each kidney to the bladder), the bladder (stores urine), or the urethra (the tube that empties urine from the bladder to the outside). Most UTIs occur in the bladder and urethra. Common symptoms include frequent need to urinate, burning while urinating, and pain in lower abdomen area.

There are different types of UTIs based on where the bacteria goes. A lower urinary tract infection occurs when bacteria gets into the urethra and is deposited up into the bladder — this is called cystitis. Infections that get past the bladder and up into the kidneys are called pyelonephritis.

Urinary tract infection symptoms may include:

• Pain or burning upon urination
• A frequent or urgent need to urinate
• Passing small amounts of urine
• Blood in the urine or or pink-stained urine
• Urines that looks cloudy
• Strong-smelling urine
• Pain, cramping in the pelvis or pubic bone area, especially in women

Upper UTIs which include the kidney (pyelonephritis) may also present with symptoms of fever, chills, back or side (flank) pain, and nausea or vomiting.

Older patients may have an atypical presentation that includes altered mental status, lethargy, and weakness.

An infection of the tube that empties urine from the bladder to the outside is called urethritis, or an inflammation of the urethra. Urethritis symptoms can include burning with urination and a discharge. Urethritis is often caused by a sexually transmitted infection and may require a different antibiotic than those used to treat UTIs.

Causes

Most UTIs in women (roughly 85%) are caused by a bacteria known as Escherichia coli (E. coli). Other types of bacteria, such as Staphylococcus saprophyticus may infrequently be present.

UTI symptoms in women and men are similar. However, urinary tract infections occur more frequently in women than in men. This is because a woman’s urethra (the tube that empties urine from the bladder) is shorter and closer to the anus than in men, allowing easier entry of bacteria like E. coli into the urethra.

Menopause, lowered levels of estrogen, and elevated vaginal pH also increase the risk of a UTI. Women are also more likely to get an infection after sexual activity or when using a diaphragm and spermicide for birth control.

Other risk factors for the development of UTIs include catheter use, urinary tract structural abnormalities, diabetes, and a suppressed immune system.

Which antibiotic should be used to treat a UTI?

There are multiple types of antibiotics used to treat urinary tract infections (UTIs). Different treatments may be recommended in different areas of the country based on regional patterns of antibiotic resistance.

Most patients with an uncomplicated UTI will begin treatment without any special diagnostic test, although a urinalysis may be performed by taking a urine sample. In a urinalysis, the chemical components of the urine are determined, and the doctor may look at urine color, clarity, and a view a sample under the microscope. A urine culture may be order, too, but is not always needed to start treatment. A urine culture can define the specific bacteria causing the UTI in more complicated cases or in the case of treatment failure.

Symptoms like burning and stinging while urinating will usually clear up in within one day after starting treatment. Be sure to finish your entire course of medication. If symptoms are still present after 2 to 3 days, contact your healthcare provider.

More extensive diagnostic procedures or imaging tests like an X-ray may be required if you continue to have frequent UTIs.

What oral antibiotics are used to treat an uncomplicated UTI in women?

The following oral antibiotics are commonly used to treat most uncomplicated UTI infections (acute cystitis):

• nitrofurantoin (Furadantin, Macrobid, Macrodantin)
• fosfomycin (Monurol)
• sulfamethoxazole-trimethoprim (Bactrim DS, Septra DS, others)

Your doctor will choose your antibiotic based on your history, type of UTI, local resistance patterns, and cost considerations. First-line options are usually selected from nitrofurantoin, fosfomycin and sulfamethoxazole-trimethoprim. Amoxicillin/clavulanate (Augmentin) and certain cephalosporins, for example cefpodoxime, cefdinir, or cefaclor may be appropriate options when first-line options cannot be used.

Length of treatment for cystitis can range from a single, one-time dose, to a course of medication over 5 to 7 days. Kidney infections may require injectable treatment, hospitalization, as well as a longer course of antibiotic, depending upon severity of the infection.

Sometimes a UTI can be self-limiting in women, meaning that the body can fight the infection without antibiotics; however, most uncomplicated UTI cases can be treated quickly with a short course of oral antibiotics. Never use an antibiotic that has been prescribed for someone else.

In men with symptoms that do not suggest a complicated UTI, treatment can be the same as women. In men with complicated UTIs and/or symptoms of prostatitis are not present, men can be treated for 7 days with a fluoroquinolone (ciprofloxacin, levofloxacin). Tailor therapy once urine cultures are available.

Are quinolones safe?

The fluoroquinolones, such as ciprofloxacin (Cipro) and levofloxacin (Levaquin) have also been commonly used for simple UTIs; however, FDA safety recommendations strongly suggest that this class be reserved for more serious infections and only be used if other appropriate antibiotics are not an option.

• An FDA safety review found that both oral and injectable fluoroquinolones (also called “quinolones”) are associated with serious and potentially disabling side effects involving tendons, muscles, joints, nerves and the central nervous system.
• These adverse effects can occur soon after administration to weeks after exposure, and may potentially be permanent.
• Patients should discuss the use of fluoroquinolones and their side effects with their healthcare provider.

However, certain oral fluoroquinolones may be appropriate for more complicated UTIs, including pyelonephritis and complicated UTIs in men with prostate involvement. For the outpatient treatment of uncomplicated pyelonephritis, the following quinolones may be appropriate. Based on resistance patterns (>10%), an inital dose of a long-acting parenteral antimicrobial, such as ceftriaxone, may be needed, or a 24-hour dose of an aminoglycoside.

• ciprofloxacin (Cipro, Cipro XR)
• levofloxacin (Levaquin)

Patients should be informed of the most current FDA warnings surrounding the use of fluoroquinolone antibiotics.

Will I need an intravenous (IV) antibiotic for a UTI?

If you are pregnant, have a high fever, or cannot keep food and fluids down, your doctor may admit you to the hospital so you can have treatment with intravenous (IV) antibiotics for a complicated UTI. You may return home and continue with oral antibiotics when your infection starts to improve.

In areas with fluoroquinolone resistance exceeding 10%, in patients with more severe pyelonephritis, those with a complicated UTI who have allergies to fluoroquinolones, or are unable to tolerate the drug class, intravenous therapy with an agent such as ceftriaxone, or an aminoglycoside, such as gentamicin or tobramycin, may be appropriate. Your ongoing treatment should be based on susceptibility data received from the laboratory.

• ceftriaxone
• gentamicin
• tobramycin

Common side effects with antibiotic use

Each antibiotic is responsible for its own unique list of side effects, and the list is usually extensive. Be sure to discuss your individual antibiotic side effects with your healthcare provider. However, there are side effects that are common to most antibiotics, regardless of class or drug:

• Vaginal yeast infections or oral thrush (candida species): Antibiotics may also change the normal flora balance in the vagina and lead to a fungal overgrowth. Candida albicans is a common fungus normally present in small amounts in the vagina and does not usually cause disease or symptoms. However, vaginal candidiasis may occur when there is limited competition from bacteria due to antibiotic treatment.
• Abdominal (stomach) upset: Antibiotics are frequently linked with stomach upset such as nausea, vomiting, lack of appetite (anorexia), stomach pain, or heartburn (dyspepsia). Taking your antibiotic with a snack or a meal may help to decrease stomach upset, if you do not need to take it on an empty stomach. If your medication causes you to vomit, contact your doctor immediately for an alternative.
• Antibiotic-associated diarrhea: Antibiotics may commonly lead to uncomplicated antibiotic-associated diarrhea or loose stools, that will clear up after the antibiotic is stopped. Broad-spectrum antibiotics can also kill the normal gut flora (“good bacteria) and lead to an overgrowth of infectious bacteria, such as Clostridium difficile (C. difficile). If the diarrhea is severe, bloody, or is accompanied by stomach cramps or vomiting, a physician should be contacted to rule out C. difficile. The most common antibiotics implicated in antibiotic-associated diarrhea are amoxicillin-clavulanate, ampicillin, cephalosporins, fluoroquinolones, azithromycin, and clarithromycin.
• Stevens Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN): Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but serious allergic drug reactions. Skin reactions like rash, skin peeling, and mucous membranes sores can occur and may be life-threatening. Antibiotics such as sulfonamides, penicillins, cephalosporins, and fluoroquinolones may result in SJS and TEN.

Related: Common Side Effects from Antibiotics, Allergies and Reactions

What about antibiotic resistance?

Resistance rates for antibiotics are always variable based on local patterns in the community and specific risk factors for patients, such as recent antibiotic use, hospital stay or travel. If you have taken an antibiotic in the last 3 months or traveled internationally, be sure to tell your doctor.

High rates of antibiotic resistance are being seen with both ampicillin and amoxicillin for cystitis (E. coli), although amoxicillin/clavulanate (Augmentin) may still be an option. Other oral treatments with reported increasing rates of resistance include sulfamethoxazole and trimethoprim (Bactrim DS, Septra DS) and the fluoroquinolones. Resistance rates for the oral cephalosporins and amoxicillin/clavulanate are still usually less than 10 percent.

Always finish taking your entire course of antibiotic unless your doctor tells you to stop. Keep taking your antibiotic even if you feel better and you think you don’t need your antibiotic anymore.

If you stop your treatment early, your infection may return quickly and you can develop resistance to the antibiotic you were using previously. Your antibiotic may not work as well the next time you use it.

Latest antibiotics for UTIs

The latest FDA antibiotic approvals for UTIs include:

Vabomere

• Vabomere (meropenem and vaborbactam) is a combination carbapenem antibiotic and beta-lactamase inhibitor. Vabomere was first approved in August of 2017.
• Vabomere is used for the treatment of adult patients with complicated urinary tract infections (including pyelonephritis) due to susceptible Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae species complex.
• Vabomere is given as an intravenous infusion every 8 hours. Dosage adjustments are required in patients with varying degrees of kidney impairment.

Zemdri

• Zemdri (plazomicin) is an aminoglycoside antibacterial for the treatment of complicated urinary tract infections, including pyelonephritis. Zemdri was first approved in February of 2015.
• Zemdri is used against certain Enterobacteriaceae in patients who have limited or no alternative treatment options. Zemdri is an intravenous infusion, administered once daily.

Avycaz

• Avycaz (ceftazidime and avibactam) is a cephalosporin and beta-lactamase inhibitor antibiotic combination used for complicated UTIs, including pyelonephritis, in adult and pediatric patients 3 months and older, and without alternative treatment options. Avycaz was first approved in February of 2015.
• Avycaz is used for complicated UTIs caused by the following susceptible Gram-negative microorganisms: Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Citrobacter freundiicomplex, Proteus mirabilis, and Pseudomonas aeruginosa.
• Avycaz is given as an intravenous infusion every 8 hours. Dosage adjustments are required in patients with varying degrees of kidney impairment.

Zerbaxa

• Zerbaxa (ceftolozane and tazobactam) is a cephalosporin and beta-lactamase inhibitor combination for the treatment of complicated urinary tract infections including pyelonephritis. Zerbaxa was first approved in December 2014.
• Zerbaxa is given as an intravenous infusion every 8 hours. Dosage adjustments are required in patients with varying degrees of kidney impairment.

See also: Treatment Options for UTIs

Are there any over-the-counter antibiotics for UTIs?

Over-the-counter (OTC) antibiotics for a UTI are not available. You should see your doctor to have your symptoms evaluated.

Your provider may recommend an OTC product called Uristat (phenazopyridine) to numb your bladder and urethra to ease the burning pain during urination. Uristat can be bought without a prescription at the pharmacy. A similar phenazopyridine product called Pyridium is also available.

Take phenazopyridine for only 48 hours, and be aware it may cause your urine to turn a brown, orange or red color which may stain fabrics or contact lenses. It may be best to not wear contact lenses while being treated with phenazopyridine.

Phenazopyridine is not an antibiotic and will not cure a UTI.

See also: Ratings of Urinary Anti-Infectives

What if I have frequent, recurring UTIs?

Within a year of havig a UTI infection, roughy one-quarter to one-half of women will have another UTI. For these women antibiotic prophylaxis (medication to help prevent a UTI) may be recommended by her health care provider. With a recurrent course of UTIs, a urine culture or imaging tests may be required for further analysis.

For recurrent UTIs, there are several antibiotic options for prevention:

• A shorter course (3 days) of antibiotics at the first sign of UTI symptoms; a prescription may be given to you to keep at home.
• A longer course of low-dose antibiotic therapy.
• Take a single dose of an antibiotic after sexual intercourse.

The choice of antibiotic is based on previous UTIs, effectiveness, and patient-specific factors such as allergies and cost. Antibiotics commonly used for recurrent UTIs can include sulfamethoxazole-trimethoprim, nitrofurantoin, cefaclor, or cephalexin.

In postmenopausal women with vaginal dryness that may be leading to recurrent UTIs, vaginal estrogen may be an effective treatment. Treatment options your doctor might recommend include: Estring(a vaginal ring), Vagifem (vaginal tablet insert), or vaginal estrogen creams (examples: Premarin, Vagifem, Yuvafem).

Can I treat a UTI without antibiotics?

UTI treatment without antibiotics is NOT usually recommended. An early UTI, such as a bladder infection (cystitis), can worsen over time, leading to a more severe kidney infection (pyelonephritis). However, a small study has suggested early, mild UTIs might clear up on their own. It’s always best to check with your doctor if you are having UTI symptoms.

Pregnant women should always see a doctor as soon as possible if they suspect they might have a UTI, as this can lead to a greater risk of delivering a low birth weight or premature infant.

Does cranberry juice prevent a UTI?

Some patients may want to use cranberry or cranberry juice as a home remedy to treat a UTI. Cranberry juice has not been shown to cure an ongoing bacterial infection in the bladder or kidney.

Cranberry has been studied as a preventive maintenance agent for UTIs. Studies are mixed on whether cranberry can really prevent a UTI. Cranberry may work by preventing bacteria from sticking to the inside of the bladder; however, it would take a large amount of cranberry juice to prevent bacterial adhesion. More recent research suggests cranberries may have no effect on preventing a UTI

• According to one expert, the active ingredient in cranberries — A-type proanthocyanidins (PACs) — are effective against UTI-causing bacteria, but is only in highly concentrated cranberry capsules, not in cranberry juice.
• However, cranberry was not proven to prevent recurrent UTIs in several well-controlled studies, as seen in a 2012 meta-analysis of 24 trials published by the Cochrane group.
• While studies are not conclusive, there is no harm in drinking cranberry juice. However, if you develop symptoms, see your doctor. Some people find large quantities of cranberry juice upsetting to the stomach.

The effectiveness of many herbal or home remedies may not have been scientifically tested to the same degree as prescription medications — or at all. Over-the-counter herbal products and dietary supplements are not regulated by the FDA. Side effects and drug interactions may still occur with alternative treatments. Always check with your health care professional before using an over-the-counter, herbal or dietary supplement for any condition. In most cases, an antibiotic is the best treatment for a UTI.

Increasing fluid intake like water, avoiding use of spermicides, and urinating after intercourse may be helpful in preventing UTIs, although limited data is available.

More Resources

• Bladder Infection
• Kidney Infections
• Urinary Tract Infection In Children
• Urinary Tract Infection In Men
• Urinary Tract Infection In Women

Symptom Checker

• Difficulty Passing Urine
• Loss of Control of Urine in Women
• Painful or Frequent Urination in Men

See also

• Alcohol and Antibiotic Interactions
• Antibiotic Resistance: The Top 10 List
• Antibiotic Shortages: A Serious Safety Concern
• Antibiotics – Common Side Effects, Allergies and Reactions
• Antibiotics and Birth Control Pill Interactions
• Middle Ear Infection FAQs (Acute Otitis Media)
• Why Don’t Antibiotics Kill Viruses?

Learn more

• Antibiotics Guide
• Anticholinergic Drugs to Avoid in the Elderly

Treatment options

• Medications for Bladder Infection
• Medications for Kidney Infections
• Medications for Urinary Tract Infection

Care guides

• Catheter-Associated Urinary Tract Infection
• Gonorrhea
• Interstitial Cystitis
• Kidney Infection
• Nonspecific Urethritis in Men
• Ovarian Abscess
• Prostatitis

Symptoms and treatments

• Bladder Infection (Cystitis)
• Pyelonephritis

Medicine.

com guides (external)

• Urinary Tract Infection Guide

Sources

1. Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2012;10:CD001321. Accessed June 3, 2019 at https://www.ncbi.nlm.nih.gov/pubmed/23076891
2. Lala V, Minter DA. Acute Cystitis. [Updated 2019 Mar 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459322/
3. Hooton T, et al. Patient education: Urinary tract infections in adolescents and adults (Beyond the Basics). Oct 11, 2018. Accessed June 3, 2019 at https://www.uptodate.com/contents/urinary-tract-infections-in-adolescents-and-adults-beyond-the-basics
4. Avycaz Product Label. Allergan. Accessed May 30, 2019 at https://www.allergan.com/assets/pdf/avycaz_pi
5. Acute complicated urinary tract infection (including pyelonephritis) in adults. Up to Date. April 1, 2019. Accessed June 3, 2019 at https://www.uptodate.com/contents/acute-complicated-urinary-tract-infection-including-pyelonephritis-in-adults
6. FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together. May 12, 2016. Accessed on June 4, 2019 at http://www.fda.gov/Drugs/DrugSafety/ucm500143.htm

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Should you take probiotics with antibiotics?

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 7, 2022.

There is controversy about whether you should routinely take probiotics with antibiotics and the question cannot be answered with a straight yes or no.

Evidence for taking probiotics with antibiotics includes a Cochrane review which reported that children who were given a course of probiotics after antibiotics had less diarrhea. Evidence against taking probiotics with antibiotics includes a 2019 Italian study that reported that the gut microbiome of people given probiotics after antibiotics took six months to return to its normal state compared to only three weeks for those not given any probiotics.

More studies are needed before a definite statement can be made.

What studies support giving probiotics with antibiotics?

A Cochrane review of 23 studies (3938 participants) investigated giving probiotics containing either one or a combination of the following: Bacillus spp., Bifidobacterium spp., Clostridium butyricum, Lactobacilli spp., Lactococcus spp., Leuconostoc cremoris, Saccharomyces spp., or Streptococcus sp.

Results from 22/23 trials that reported on the incidence of antibiotic-associated diarrhea show a significant benefit from probiotics compared to active, placebo, or no treatment control (8% in the probiotic group compared to 19% in the control group). None of the 16 trials (n = 2455) that reported on side events documented any serious side events attributable to probiotics with the most common ones being rash, nausea, gas, flatulence, abdominal bloating, abdominal pain, vomiting, increased phlegm, chest pain, constipation, taste disturbance, and low appetite. The author’s concluded that there was a protective effect of probiotics for preventing antibiotic-associated diarrhea. The relative risk was 0.46 (95% CI 0.35 to 0.61) and the NNT was 10.

The authors considered Lactobacillus rhamnosus or Saccharomyces boulardii at 5 to 40 billion colony forming units/day to be the most appropriate choice. They also commented that although no serious adverse events were observed among the otherwise healthy children in these trials, serious adverse events have been observed in severely debilitated or immuno-compromised children with underlying risk factors (eg, central venous catheter use), and advised that probiotics should be avoided in pediatric populations at risk for adverse events until further research has been conducted.

What studies do not recommend giving probiotics with antibiotics?

Researchers from the Weizmann Institute of Science in Israel and other institutions reported that the gut microbiome took longer to return to normal in those people given an 11-strain probiotic treatment for four weeks following a course of antibiotics. This was despite the probiotics effectively colonizing the gut with healthy bacteria. The trouble was the presence of the new bacteria and yeasts strains prevented the gut microbiome from returning to normal for the full six month study period.

Conversely, the gut microbiome in those given no probiotics returned to normal within three weeks of going off the antibiotics. “ The authors did conclude that this study just examined one type of probiotic, and a different probiotic may be helpful in patients taking different antibiotics. However, they did point out the findings of the study imply that the traditional practice of taking a probiotic after antibiotic may not be beneficial.

More research is needed to determine if other options to strengthen the gut microbiome, such as fermented food products (eg, sauerkraut and kimchi) or fecal transplantation, is beneficial. Studies have shown that autologous fecal transplantation, which involves collecting stool samples before going on antibiotics and freezing them, brought the gut microbiome back to normal within eight days once the stool was returned to the gut following antibiotic treatment. It took 21 days for the gut microbiota in the group that didn’t undergo fecal transplantation to return to perfect health. Currently, however, the only approved indication for autologous fecal transplantation is for people with C. difficile colitis, which is an inflammation of the colon caused by the bacteria Clostridium difficile.

What are the most common side effects of probiotics?

The most common side effects reported with probiotics in clinical trials included:

• abdominal bloating
• abdominal pain
• chest pain
• constipation
• flatulence
• gas
• increased phlegm
• low appetite
• nausea
• rash
• taste disturbance
• vomiting.

What is the gut microbiome?

Our digestive tract is home to trillions of bacteria as well as fungi and viruses – these are known as the gut microbiome.

The makeup of this biome is largely genetically determined; however, it is heavily influenced by several factors such as whether we are born naturally (vaginally) or by cesarean section, if we were breastfed, our use of antibiotics, and our exposure to chemicals, pesticides, and other toxins.

Scientists now know that this microbiome is critical to our overall well-being. Some call it our second brain. Small imbalances can cause significant changes to our mental health and in the appearance of our skin and has been linked to almost every known condition such as Alzheimer’s disease, multiple sclerosis, rheumatoid arthritis, and Type 2 diabetes.

An imbalance may also cause constipation, diarrhea, skin rashes, yeast infections, and a suppressed immune system. Your likelihood of putting on weight also comes down to your microbiome and the influence it has on your response to insulin and thyroid gland function.

What are probiotics?

Probiotics are live bacteria and yeasts that are beneficial for health. They are often referred to as ‘good’, ‘helpful’, or ‘healthy’ bacteria.

Probiotics are available as dietary supplements and can be brought over the counter from a drug store, pharmacy, or health store. Probiotics are also found naturally or added to foods such as dark chocolate, yogurt, miso soup, pickles, sauerkraut, tempeh, or kefir.

What is the rationale behind taking probiotics with antibiotics?

Taking an antibiotic for an infection can kill beneficial bacteria that live in your gut.

Probiotics may be taken orally to restore any imbalance in the normal intestinal or urogenital flora. This is the rationale behind taking probiotics with antibiotics. Severe antibiotic-induced diarrhea can also lead to an infection with Clostridium difficile, also known as C. difficile, a bacteria which can cause dangerous inflammation in your colon (colitis).

Experts have hypothesized that If you suffer from stomach cramping, gas or diarrhea when you take antibiotics, adding a probiotic may help to lessen, or even prevent, these symptoms. The addition of a probiotic will also reintroduce helpful bacteria into your digestive tract that have been killed or had their numbers reduced by the antibiotic.

How should I take probiotics with antibiotics?

If you do decide to take a probiotic with an antibiotic, start it the same day you start the antibiotic, but do not take it at exactly the same time as the antibiotic. Allow at least two hours to elapse after taking your antibiotic before you take your probiotic.

Probiotics are usually taken twice a day on an empty stomach. They should then be continued for at least several weeks after your course of antibiotics has finished, although some people take probiotics daily to not only continue to help digestion but to boost their immune system and enhance the absorption of some nutrients.

If you wish to take probiotic supplements, choose a high-quality probiotic made by a reputable company that contains at least one of the following: Lactobacillus rhamnosus, Saccharomyces boulardii, or Bifidobacterium sp. at 5 to 40 billion colony units/day.

Do prebiotics help return the gut microbiome to normal?

Prebiotics are foods for probiotics and include fiber-rich foods such as fruits, vegetables, cereals.

Mixing prebiotics with probiotics, such as yogurt with fruit and cereal or sauerkraut with a vegetable stir fry could be helpful for your gut, although there is no scientific evidence to support this.

Good prebiotic foods include vegetables such as artichokes, asparagus, garlic, onions, and any green vegetable; fruits such as bananas, berries, and tomatoes; herbs such as chicory or garlic; grains like barley, oat, and wheat; and other fibers such as inulin that may be available on its own or added to foods such as granola bars, cereal, and yogurt.

References

• Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2015 Dec 22;(12):CD004827. doi: 10. 1002/14651858.CD004827.pub4. Update in: Cochrane Database Syst Rev. 2019 Apr 30;4:CD004827. PMID: 26695080.
• Suez J, Zmora N, Zilberman-Schapira G, et al. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell. 2018 Sep 6;174(6):1406-1423.e16. doi: 10.1016/j.cell.2018.08.047. PMID: 30193113.
• Goderska K, Agudo Pena S, Alarcon T. Helicobacter pylori treatment: antibiotics or probiotics. Appl Microbiol Biotechnol. 2018 Jan;102(1):1-7. doi: 10.1007/s00253-017-8535-7. Epub 2017 Oct 26. PMID: 29075827; PMCID: PMC5748437.
• Neut C, Mahieux S, Dubreuil LJ. Antibiotic susceptibility of probiotic strains: Is it reasonable to combine probiotics with antibiotics? Med Mal Infect. 2017 Nov;47(7):477-483. doi: 10.1016/j.medmal.2017.07.001. Epub 2017 Aug 7. PMID: 28797834.
• Guandalini S. Probiotics for prevention and treatment of diarrhea. J Clin Gastroenterol. 2011 Nov;45 Suppl:S149-53. doi: 10. 1097/MCG.0b013e3182257e98. PMID: 21992955.
• Do probiotics provide effective and safe protection against antibiotic-associated adverse effects? Best Practice Journal > 2015 > BPJ: 68 > Do probiotics provide effective and safe protection against antibiotic-associated adverse effects? https://bpac.org.nz/bpj/2015/june/probiotics.aspx

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Medical Disclaimer

New Generation Broad Spectrum Antibiotics: Drug List

CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED. Antibacterial Antibacterial ointments and creams Antibacterial powders Antibiotics in capsules Antibiotics in tablets

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Contents of the article

• When to prescribe broad-spectrum antibiotics in tablets
• Categories of modern antibiotics of the latest generation of broad-spectrum
• What pathologies are used for
• Ask an expert on the topic of the article
• Sources of which does no harm, and some even benefit. But certain types of them cause various diseases, which antibiotics help to cope with. These drugs inhibit the growth of bacteria and suppress their vital activity.

  However, most of them can only affect a certain group of microorganisms. This feature makes it difficult to select the right drug and slows down the treatment process. In such cases, broad-spectrum antibiotics come to the rescue. They fight several pathogens at once and are used to treat a wide variety of infectious pathologies.

  When to prescribe broad-spectrum antibiotic tablets

  These antibacterials are versatile drugs that can cope with several infections at once.

  They are indispensable if:

  • it is not possible to quickly determine the causative agent of the infection, and a preliminary diagnosis is made on the basis of patient complaints. The antimicrobial agent used will help to contain the further development of the disease until the true pathogen is identified;
  • drugs with a narrow spectrum of action cannot cope with pathogens;
  • non-standard superinfection with the presence of several types of bacteria at once;
  • the prevention of infectious processes is required after surgery or cleaning of wound surfaces.

  Modern drugs are available in a variety of forms: in addition to traditional tablets and solutions for parenteral administration, pharmacists offer antibiotics in the form of suppositories, ointments, sprays. For children, syrups are used that have a pleasant taste and do not cause negative emotions in young patients.

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  Categories of modern antibiotics of the latest generation with a wide spectrum of activity

  Antibiotics successfully fight bacteria. However, many microorganisms become resistant to them and the means used lose their effectiveness. Microbes are particularly well adapted to commonly used antibiotics. This forces pharmacologists to constantly develop new drugs. Therefore, today there are already several generations of antibacterial agents.

  New generation antibiotics have a stronger effect on microorganisms. They are less toxic, but this does not mean that they are completely safe for the body.

  The list of modern tools is presented in the table.

  Group	How they work	Drugs
  Tetracyclines	Stop the growth and development of bacteria, but do not kill them	Tetracycline, Doxycycline
  Fluoroquinolones	Kill bacteria. More active against gram-negative microorganisms, mycoplasmas and chlamydia	Moxifloxacin, Levofloxacin
  Semi-synthetic penicillins	Effectively kills bacteria in combination with clavulanic acid.	Ampicillin, Amoxicillin
  Cephalosporins	Similar in structure to penicillins and have a similar effect. But more resistant to microbial enzymes.	Ceftriaxone, Cefepin
  Aminoglycosides	Destroy mycobacterium tuberculosis, tularemia and plague pathogens.	Streptomycin, Amikacin
  Carbapenems	Destroy pathogens of chronic bacterial bronchitis, skin and urinary tract infections	Meropenem, Imipenem

  All products Ceftriaxone

  11 reviews

  All products Meronem

  5 reviews

  All products Levofloxacin

  21 reviews

  All products Tetracycline

  20 reviews

  What pathologies are used

  Due to its ability to act on different types of bacteria, the same broad-spectrum antibacterial agent can be used to treat a variety of diseases.

  Antibiotics are used in their practice:

  • Urologists – drugs successfully cope with pathologies of the urinary tract, kidneys, prostate. They are also used to treat genital infections.
  • Therapists prescribe antibiotics for angina, bronchitis, pneumonia. The drugs do not affect viruses, but are used to treat complications of SARS.
  • Infectionists – intestinal infections are quite common among children and adults. The penetration of pathogens into the body occurs through unwashed hands, water, food. Dysentery, salmonellosis, giardiasis and other infections are treated with antibiotics.
  • Dermatologists – drugs have found their application in the treatment of such pathologies as erysipelas, pemphigus of newborns, lichen. Often in dermatology, antibiotics are used in the form of ointments. Also, antibacterial agents are often prescribed for wound injuries of the skin and burns.
  • Surgeons – despite the fact that interventions are performed under aseptic conditions, it is not always possible to avoid purulent complications. Drugs in such cases are selected individually.
  • Dentists – Inflammatory processes that develop in the oral cavity can be very dangerous. Therefore, antibiotic therapy is mandatory for treatment.

  Thanks to the advent of antibiotics, doctors have been able to cope with many diseases that were previously considered incurable.

  However, they should not be used without a doctor’s prescription. Uncontrolled use of drugs will only lead to the fact that some pathogens will develop resistance and the next time it will be much more difficult to treat the disease.

  Ask an expert about the topic of the article

  Any questions? Ask them in the comments below and our experts will answer you. There you can also share your experience with other readers of Megasovets.

  Resources

  1. Antibiotics: Uses, NHS
  2. Antibiotics, US National Institutes of Health
  3. Antibiotics: Considerations, UK National Health Service

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  Recommended treatment for sexually transmitted infections revised to reflect rising levels of antibiotic resistance

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  In response to the growing threat of antibiotic resistance, the World Health Organization (WHO) has released new treatment guidelines three common sexually transmitted infections (STIs).

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  \nChlamydia, gonorrhea, and syphilis are all bacterial infections that can usually be treated with antibiotics. However, these STIs often go undiagnosed and are increasingly difficult to treat as some antibiotics have lost their effectiveness through misuse or overuse. An estimated 131 million people develop chlamydia, 78 million gonorrhea and 5.6 million syphilis each year.

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  \nIn recent years, antibiotic resistance of these STIs has increased rapidly and the choice of treatments has narrowed. Among these STIs, gonococci have developed the greatest resistance to antibiotics. Multidrug-resistant strains of gonococci have already been identified that do not respond to any available antibiotics. In the case of chlamydia and syphilis, antibiotic resistance is also observed, albeit to a lesser extent, and this jeopardizes prevention and rapid treatment.

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  \nSTIs, left undiagnosed and untreated, can lead to serious complications and long-term health problems in women, such as pelvic inflammatory disease, ectopic pregnancy and miscarriage, while gonorrhea and chlamydia, if left untreated, can lead to infertility in both men and women. Chlamydia, gonorrhea, and syphilis can also increase the risk of HIV infection by two to three times. Left untreated for an STI in a pregnant woman increases the chance of stillbirth and death of the newborn.

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  \n“Chlamydia, gonorrhea and syphilis are significant public health problems worldwide, affecting the quality of life of millions of people, causing serious illness and sometimes death. The new WHO guidelines highlight the need for timely treatment of these STIs with appropriate antibiotics at the correct doses to limit their spread and improve sexual and reproductive health. To do this, national health services need to monitor patterns of antibiotic resistance in these infections in their countries,” said Ian Askew, Director of the WHO Department of Reproductive Health and Research.

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  \nThe new recommendations are based on the latest evidence available on the most effective drugs for these three sexually transmitted infections.

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  Gonorrhea

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  \nGonorrhea is a common STI that can lead to infection of the genitals, rectum, and throat. With the advent of each new class of antibiotics for the treatment of gonorrhea, antimicrobial resistance has emerged and increased. Due to widespread resistance, older and cheaper antibiotics have lost their effectiveness in treating the infection.

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  \nDue to the growing threat of antibiotic resistance, WHO urges countries to update their national gonorrhea treatment guidelines. National health authorities should monitor the levels of resistance to various antibiotics in gonococcal strains circulating in their populations. The new guidance calls on health authorities to recommend that clinicians prescribe the antibiotic that is most effective in the context of local patterns of resistance. According to new WHO guidelines, the use of quinolones (a class of antibiotics) is not recommended for the treatment of gonorrhea due to widespread high levels of resistance.

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  Syphilis

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  \nSyphilis is spread by contact with a wound on the genitals, anus, rectum, lips, and mouth, or from mother to child during pregnancy. Infection transmitted to a fetus by a woman with untreated syphilis often results in fetal death. In 2012, it was estimated that 143 000 early fetal deaths/stillbirths, 62 000 neonatal deaths and 44 000 preterm/low birth weight births resulted from mother-to-child transmission of syphilis.

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  \nNew WHO guidance strongly recommends a single dose of benzathine penicillin, an injectable antibiotic that a doctor or nurse injects into the buttock or thigh muscle of an infected patient, to treat syphilis. It is the most effective drug for syphilis, more effective and cheaper than oral antibiotics.

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  \nAt the Sixty-ninth World Health Assembly in May 2016, benzathine-penicillin was recognized as one of the essential medicines, the stocks of which have been significantly shortened over the past several years. WHO receives reports of shortages from representatives and providers of antenatal care services in countries with a high burden of syphilis from the three WHO regions. WHO is working with partners to identify countries that are short of the drug and is helping to monitor the global availability of benzathine-penicillin to bridge the gap between national demand and supply of this antibiotic.

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  Chlamydia

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  \nChlamydia is the most common bacterial STI, and people with this infection often co-infect with gonorrhea. Symptoms of chlamydia include discharge and a burning sensation when urinating, but most people have no symptoms of the infection. Even in the absence of symptoms, the infection can have negative consequences for the reproductive system.

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  \nWHO urges countries to immediately move to use the updated guidelines, in line with recommendations of the Global Health Sector Strategy on STIs (2016-2021) endorsed by governments at the World Health Assembly in May 2016. The new guidelines are also in line with the Global Action Plan to Combat Antimicrobial Resistance, which was adopted by governments at the World Health Assembly in May 2015.