drugs used for the treatment of urinary tract infections with different antibiotics and lifestyle changes

1. Drugs in UTI
By
Dr. Mohammad Tamhid
Department of Pharmacology KMC

2. Learning Objectives
 Define UTI.
 Describe Complicated and Uncomplicated UTI.
 Describe Treatment of UTI.
 Describe different Drugs in UTI.

3. Introduction
- UTIs are bacterial infections of the urinary system.
- Common causes: E. Coli, klebsiella, pseudomonas,
enterococcus

4. different types of Urinary Tract Infections (UTIs):
1. Uncomplicated UTI: Occurs in healthy individuals with a normal urinary tract, typically caused
by E. coli.
2. Complicated UTI: Occurs in individuals with underlying medical conditions, such as diabetes,
kidney stones, or an abnormal urinary tract, increasing the risk of treatment failure or recurrence.
3. Recurrent UTI: Defined as three or more episodes of UTI in a 12-month period.
4. Catheter-associated UTI (CAUTI): Develops in patients with urinary catheters.
5. Asymptomatic bacteriuria (ASB): Presence of bacteria in the urine without symptoms.

5. different types of Urinary Tract Infections (UTIs):
6. Symptomatic UTI: Presence of symptoms such as burning urination, frequent urination, or abdominal pain.
7. Lower UTI: Infection of the bladder (cystitis) or urethra (urethritis).
8. Upper UTI: Infection of the kidneys (pyelonephritis) or ureters (ureteritis).
9. Pyelonephritis: Infection of the kidney tissue, potentially leading to kidney damage.
10. Urosepsis: A condition occurring when bacteria enter the bloodstream through the urinary tract.

6. Drugs
1. Antibiotics:
- Nitrofurantoin
-
Trimethoprim/sulfamethoxazole
- Amoxicillin/clavulanate
(Augmentin)
- Ciprofloxacin (Cipro)
- Levofloxacin (Levaquin)
- Cephalexin (Keflex)
2. Pain relievers:
- Phenazopyridine (Pyridium) -
helps with urinary discomfort and
pain
3. Anti-inflammatory drugs:
- Ibuprofen- helps with pain
and inflammation

7. Drugs Choices
- First-line antibiotics:
- Nitrofurantoin (Macrobid) for uncomplicated UTIs.
- Trimethoprim-sulfamethoxazole (Bactrim) for uncomplicated UTIs.
- Second-line antibiotics:
- Fluoroquinolones (Ciprofloxacin, Levofloxacin) for complicated UTIs.

8. Resistant UTI
Resistant Organisms
 Cephalosporins (Ceftriaxone, Cefixime) for complicated UTIs or
resistant organisms.
 Beta Lactam Antibiotics
 Culture Based

9. Important considerations:
 Severity of infection.
 Antibiotic resistance
 Patient allergies or sensitivities
 Pregnancy or breastfeeding status (Ceftriaxone, Cefixime)

11. Fosfomycin
why a useful drug…..?
 Fosfomycin is a broad-spectrum bactericidal antibiotic which is active against both
Gram-positive and Gram-negative bacteria.
 Its unique mechanism of action may provide a synergistic effect to other antibiotics
including beta-lactams, aminoglycosides, and fluoroquinolones
 High susceptibility against E.coli and Lower resistance rates even after long-term usage.
 Optimum urinary concentration allows once daily dosing
 Established efficacy and safety with single-dose therapy and has better patient
compliance
 Useful in critically ill patients and for surgical prophylaxis and transplant infections

12. Other measures/ Natural remedies
In addition to these drugs, some natural remedies and lifestyle changes may also help
alleviate UTI symptoms, such as:
- Drinking plenty of water
- Urinating when you feel the need
- Avoiding certain foods that irritate the bladder
- Practicing good hygiene
- Considering cranberry juice or supplements (although evidence is mixed