5 best antibiotics for UTI. Take this, not that!

What are best antibiotics for UTI? When you are sick with a urinary tract infection, you need a quick fix and this often means a course of antibiotics for UTI.

Sometimes you are so overwhelmed with UTI symptoms, you’ll take anything that your doctor prescribes. However, it is better to be careful and informed about your treatment options.

Need antibiotics now? Check out this $20 online prescription service, licensed in 25 states.

Are antibiotics necessary in your case?

Antibiotics should not be treated lightly, especially given increasing risk of patients developing antibiotic-resistant bacteria.

  • Some argue that symptoms of UTI like burning and urge to urinate are not always indicative of a urinary tract infection.
  • Antibiotics alone are also useless against mature bacterial biofilms.
  • Small doses of antibiotics could actually promote the growth of bacterial biofilms.
  • Molecules, available in NAC supplements can increase the effectiveness of antibiotics and help you fight mature bacterial biofilms.
  • Natural supplements like D-Mannose could be in some cases better than antibiotics

Therefore physicians must complete additional tests before prescribing antibiotics and accurate local data to understand potential antibiotic resistant in their patient population.

Can you self-diagnose a UTI? In a recent study less than 50% women who reported to the physician with UTI symptoms, indeed had a urinary tract infection.

Most predictive factor for UTI was the combination of urgency, burning during urination and pyuria (presence of white cells in urine sample).

The study suggests that more physicians should order wet mount microscopy test (not the same as urine dipstick test) for the presence of white cells in urine sample prior prescribing antibiotics for UTI.

Did you notice blood in your urine, is it cloudy or has a “funny” smell to it? These are examples of symptoms that are highly indicative of a UTI, versus lower abdomen pain and burning with urination that could be attributed to bladder inflammation without an acute infection.

Therefore, whenever you are offered antibiotics for UTI, make sure to ask for a urine culture test or wet mount microscopy test.

Best antibiotics for UTI treatment

According to International clinical guidelines on how to treat UTI, below are the best antibiotics for UTI. I have listed them in preference order according to the guidelines.

If you do not recognize a name or two on the list this is because some of these drugs are available in the EU, but not in the USA.

This list is only applicable for otherwise healthy and non-pregnant adults.

  1. Nitrofurantoin

    Brand names: Macrobid, Nitrofurantoin, Furadantin, Furalan, Macrodantin.

    This is my favorite antibiotic for UTI treatment because it has the least impact on gut flora. If you are taking any of these drugs, check out my post on pros and cons of nitrofurantoin. It works best for UTIs caused by E. coli bacteria.

  2. Trimethoprim-sulfamethoxazole.

    Brand names: Septra, Bactrim, Sulfatrim.

    These antibiotics for UTI are becoming less popular due to increased resistance of E. coli to this medication. In some studies, more than 34% of women diagnosed with a UTI had E.coli bacteria resistant to this group of antibiotics.

  3. Fosfomycin trometamol

    Brand name: Monurol.

    A single oral dose of fosfomycin trometamol 3 g (the approved dosage) achieves high concentrations in urine. Results of recent randomized trials show that single-dose was enough to treat an uncomplicated UTI (compared to 3 to 7-day course of ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin) in women.

    This antibiotic works well for most bacteria causing UTI and has not been contributing to antibiotic resistance.

  4. Pivmecillinam

    Brand names: Alexid, Dysedin, Penomax, Melysin, Selexid, Relexid, Emcil, Pivicil.

    Pivmecillinam is an oral antibiotic with excellent clinical efficacy in the treatment of uncomplicated UTIs.

    Nordic countries are using this antibiotic with few problems, but, despite this, physicians in other countries are less familiar with it. In recent clinical studies, it was effective for infections caused by E. coli bacteria that are already resistant to other popular antibiotics, including fluoroquinolones. This antibiotic also has minimal impact on your gut’s microbiota.

  5. Fluoroquinolones, ofloxacin, ciprofloxacin, and levofloxacin.

    Brand names: Cetraxal, Cipro, Ciloxan. Update from 08/2016: read this update on Cipro from FDA.

    Unfortunately, this antibiotic is still on the list of best antibiotics for UTI. At the same time, this antibiotic is no longer recommended for an uncomplicated UTI due to a plethora of horrible irreversible side effects it might cause.

    Do not accept Cipro as a prescription for an uncomplicated UTI and get familiar with dangers of using Cipro. Ask and educate your physician for alternatives (anything from the list above).

Note: Amoxicillin and ampicillin are considered but not recommended. Also, read about Cefdinir for UTI and why it is not included in Top 5 best antibiotics for UTI.

Bacterial biofilms and antibiotics

Have you heard about bacterial biofilms? Most likely, neither you, no your doctors know about them. However, bacterial biofilms could be to blame for your persistent infections and possible resistance to antibiotics.

I quote a dozen of clinical studies in this post about bacterial biofilms and their interaction with antibiotics.

Over the counter products to supplement antibiotics for UTI

When starting with antibiotic treatment consider using D-Mannose and special probiotics to speed up recovery and prevent UTIs from recurring.

D-Mannose will help you to flush the bacteria from your bladder, while vaginal probiotics will maintain good bacteria and help to prevent future infections. Check this post if you are not familiar with D-Mannose supplement.

Which antibiotics did your physician prescribe to you? Please post in comments below and remember to let me know which country you are from.



  1. Where can Iget D-Mannose powder ? Should I take a vitamin supplement with it or does it come with vitamin C. Will D-Mannose bother my kidneys. I live in Florida USA. I was told it is only sold in Canada.


Please enter your comment!
Please enter your name here