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.

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.
  • 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.


In a recent study less than 50% women who were 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.

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 women.

  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.

    Read about special probiotics and their role in preventing UTIsLearn how probiotics help to prevent recurrent UTI

  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.

    My UTI Guides

    1. 8 Holistic Strategies To Prevent UTI
    2. 7 Unexpected Facts About Vaginal Discharge And UTI
    3. Oral Sex And UTI: All You Need To Know
    4. Can I Get a UTI From My Partner?
    5. Ulitmate Guide For Bladder Health Supplements
    6. D-Mannose Brands Review, 2018
    7. Bacterial Biofilms As The Main Cause Of Chronic UTI
  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.

Best practices when taking antibiotics for UTI

Needless to say, make sure to take all pills regardless of how well you feel. You need to try to take antibiotic pills at regular intervals. Also, check out this post with 10 best practices when taking 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. I get UTI’s so frequently and I had to resort to antibiotics more often. I had tried everything natural to try and stop it, but nothing has worked better than the Lady Soma Cranberry Concentrate. I’m not getting anything free for writing this, I just wanted to write a review for the girl out there like me that might read these words.

    I tried the Lady Soma Cranberry Concentrate on a whim because my cranberry pills weren’t working, straight d-mannose wasn’t working. I take two anytime I feel even a hint of anything happening and it takes care of it. I also take one after sex. This is amazing and I thank the people out there who make it cuz without it I would have to resort to antibiotics, and now I only have to resort to them in emergencies!

  2. Hi Anastasia V, thank you for the information. Please beware of Nitrofurantin, aka Macrobid, Macrodantin, Furodantin etc which is at the top of your list. My mother died a tortuous death from this drug destroying her lungs, which we found too late was a common and well known side effect of this drug which has now been on the market over 60 years. I found people younger than me have died from it, not just the elderly and to this day find stories of people whose loved one experienced the same awful death from this drug that she did. Nitrofurantoin acts by delayed symptoms (which can appear even after the drug has stopped and the damage can continue to progress after the drug has stopped). It is very slow onset and mimics other common respiratory ailments. Mom went to the emergency for a fall, they decided she fell because of UTI infection which made her dizzy so they gave her this drug. She had been successfully treated for UTI many times so I didn’t realize till too late they had given her something different. For some reason they took a scan of her lungs at the time they gave her this, and they were then beautiful and clear, and she was doing well otherwise and feeling better than she had in a long time. Then she began to have a cough, they thought she had bronchitis, but it continued to worsen, then they thought it was COPD. Then she began to need oxygen 100% of the time, Within 7 months she was hospitalized and seen by several skilled physicians for a week who all believed she had severe pneumonia till a pulmonary specialist walked in and pointed to the Nitrofurantoin. The drug was stopped but by that time it was too late, the scan showed her lungs completely destroyed by scar tissue from this drug. The scarring continued to progress after the drug was stopped and within 9 months she was gone with admitted cause of death being Nitrofurantoin.

    • Hi Brenda,
      So sorry for your loss, this is horrible.
      Thank you so much for writing this, it’s great when readers can share their personal experience with antibiotics and raise the awareness of the potentially dangerous side-effects. To my understanding, this is a pretty rare and known side-effect, the drug should be discontinued at the first symptoms of lung distress and it’s recommended that physicians monitor lung function regularly if administering this medication. Again, thank you so much for taking time to share. Best wishes,

  3. Hi, thank you for the posts. I’m losing my mind. 9 days In on leviquin I had to stop. I’ve been taking it on and off for 13 years. The only thing that helped me. My question is. 13 years ago I went to uroligist after my Dr. Could not find a reason why my uti want going away. If I tried bactrim now would it work? The side effects i suffered with Leviquin were mainly lack of sleep. This time my body was aching and I could feel my knees and ankles going.

  4. I have been getting UTIs on and off for over a year. My gp gives me Macrobid (three times) which means that I have to take time off work because I feel so bad when taking this med. In between I have tried herbs, Buchu, Corn silk, D mannose none of them work. I feel exhausted and really fed up. Exhaustion is one of the main symptoms along with very smelly wee and lower abdominal pain. No burning at least, nothing seems to work

    • Hi Sue,
      Sounds like you have been through a lot. Don’t give up though, there is always a way.
      When do you tend to get your UTIs, did you notice what triggers them?
      Do you know which bacteria causing your UTIs?
      Have you been checked for stones?
      Any hormonal changes recently?
      There are still plenty of things you could try. Start with this post about bacterial biofilms, see if your doc will approve using NAC next time you are taking an antibiotic.
      Corn silk is good to reduce inflammation, maybe you need something stronger. Did you discuss NSAIDs instead of antibiotics with your doctor?
      Also, while D-Mannose is great for some, you might want to try something with a wider antimicrobial range. Check with your doc if he approves preventive garlic (I would combine it with NAC) or Uva Ursi.
      Let me know.
      It’s going to be OK,

  5. I have a drug-resistant pseudomonas infection in the urinary tract. Today I am on my way to get a PICC line and IV antibiotics of Gentamicin. There are three antibiotics left that will treat my infection. I don’t know how much time I have left. Every time I get one….they just want to give me more antibiotics and it never goes away completely. So I’ve kind of accepted the fact that I’m probably going to die from this. I have constantly been researching ways and alternative Therapies but a lot are not even practiced in the US. The only thing I’ve had success with is Master Tonic that seems to help keep it away for a little while. If anybody has any helpful tips please let me know

  6. I was prescribed Tavaloxx yesterday. After just one dose at 9am i could not sleep from the irregular heartbeat.
    I went back to the doctor and he prescribed Ciploxx. Which is basically the same thing. I have had severe wind and upper ribcage discomfort all day. This is all for a mild UTI. Is South Africa not aware of the dangers of these drugs?

    • Hi Christine, so sorry you have to go through this. I don’t think there is one country that does good jobs in disseminating UTI research to their doctors. In most cases, GPs are the ones dealing with UTIs and they all treat it as a minor issue, prescribing antibiotics as required by standard guidelines. Since UTIs are kind of minor problem, there is little motivation on doctor’s behalf to dig deeper and stay up to date on news and research and this is totally understandable, they probably spend most of their time catching up on research about COPD, diabetes, hypertension and other “diseases of the century”.
      Unfortunately, once you are on it, the best for you is to finish the course but do work on prevention and see if you could get NACs to go with the treatment. I hope it’s not more than three days?
      Best wishes,

  7. I have had recurring UTI for the last 2 years (every 1-3 months). Once or twice, the symptoms were serious (urge to urine, pain etc) and recently, almost bearable (I could work) with just some pain during urination and intense urge every 1-2 hours.
    The usual medication I was given by my GP or urogynae is augmentin/clamovid or ciprox (depending on the urine culture). These 2 usually gives me diarrhea by day 3 and causes slight yeast infection as well.
    Today, a different GP prescribe moxifloxacin400mg (5 days) plus a single dose of monurol after testing positive for e coli. The last e coli infection was 1 month ago. Hopefully it will work this time!

  8. I have been on cipro and bactrim pyridum and diflucan and my doctor says its not getting any better his words were lets hope this next antibiotic works

  9. Hi, I was diagnosed today with a UTI, and the doctor felt it was serious enough to prescribe Cipro. Even though I didn’t have any bladder symptoms until yesterday, I have been having night sweats and chills for a week, I have pain in my left back flank and front abdomen, and have been very tired. I noticed the above recommendations are for non-complicated UTIs. Do you have a recommendation alternative for the Cipro?
    Thank you,

    • Hi Sharon,
      Sorry to hear! Sounds pretty serious, I understand why he/she prescribed you Cipro. Here, check out this post, see what your doctor thinks about it. Do not delay taking antibiotics though, pyelonephritis can be life threatening. All antibiotics have side-effects, but when the infection spreads to kidneys, the reward of stopping the infection out-weights risks of side-effects. Follow the recommendation that your doctor and pharmacists provided you with Cipro. I hope for your quickest recovery,

  10. Three months, in September, I was very ill with sepsis and I had to stay In hospital. I am still being treated by my GP for the UTI (underlying cause of the sepsis). I have just finished a course of six cyprofloxacin antibiotics and then in a week I have to give another urine sample to the hospital to be tested for sepsis and E-coli. I’ve also seen a urologist privately but the only test he did was a flexible cystoscopy and I return to his surgery in a month. I’ve had various urine tests and antibiotics prescribed by my GP and still I am awake all night going to the loo and again during the day.
    I have had the UTI since last January 2017 and I am very tired. What can I do to get help?

    • Hello there,
      Sepsis is pretty serious, I’m glad it was dealt with in a timely manner.
      What kind of surgery the urologist suggests?
      What other symptoms do you have besides urgency?
      Here are couple posts for you to check out: alternative medicine for chronic UTI speak about how symptoms sometimes are caused by damaged bladder lining rather than bacteria and this one covers a bunch of supplements you can try with your doctor’s permission.
      None of the supplements are meant to replace antibiotic treatment, rather give it a boost.
      Ask your doctor if you can try the following protocol:
      1) D-Mannose, preventive supplementation dose every day. If your vaginal flora is weak, it means you keep re-introducing E.coli to your urethra. D-Mannose could help to keep the pathogenic bacteria out of your bladder.
      2) Three days of raw garlic therapy: 6-7 gloves daily, cut into tablet size pieces (2-3 gloves at a time), taken three times daily. This is to help fight whatever bacterial colonies you still might have.
      3) NAC: two capsules daily (one in the AM, one at night). This is to combat bacterial biofilms.
      4) Aloe vera capsule and Marshmallow root (or cornsilk) tea, daily. This is to help your bladder to restore itself and hopefully decrease the urgency
      5) Vegetable diet for at least two weeks with plenty of fiber and berries, plenty of water with lemon. Excluding coffee, soda drinks, sweets, processes carbohydrates. This will help you to balance your urine pH and introduce various elements that could help to speed up recovery.
      6) Two types of probiotics: Wide range quality probiotics to restore gut flora and vaginal flora strains
      If you are pre- or post-menopausal, ask your doctor for topical estrogen.
      Best of luck,

  11. To expand on the above topic post, here is the FDA release regarding fluoroquinolones.

    Tell your doctor you don’t want to take fluoroquinolones for simple UTIs. Bactrim, Nitrofurantoin, and cephalosporins (e.g cephalexin, cefdinir, cefuroxime) are all much safer options. Also, if you live in a major city or urban area rates of fluoroquinolone resistance are increasing at alarming rates.

  12. Warning!!! If you value your health at all, Do NOT take fluoroquinolone antibiotics ( FQs) – Cipro, Levaquin, avelox, factive, & many more in pill, IV, ear or eye drop, skin cream form. The FDA now even warns that the risks far outweigh the benefit because they can cause “disabling permanent” damage to tendons & nerves. These effects can happen weeks, months & years after dosing. Because FQs mechanism of action is to destroy DNA, & they can attack your healthy cells mitochondria, which is a medical disaster: body-wide tendon ruptures, nerve damage, cartilage destruction, retinal detachment, psychoses because these are the only antibiotics that cross the blood-brain barrier. See “fluoroquinolone toxicity group” on Facebook for 1st hand accounts of devastating damage from these antibiotics to thousands of people.
    Also see FB : Levaquin Amy Moser – she’s had 20 surgeries on joints/tendons in 7 years from Levaquin. FQs were originally developed as chemo, not antibiotics. Erin Brockovich has a class action suit against the makers of FQs for aortic dissection. They are implicated in Gulf War illness…
    They are drugs of Last Resort for things like Anthrax poisoning, Plague & bacterial pneumonia after all other antibiotics fail – NOT UTI’s ! BTW – your doctor probably is not aware of the FDA warning & the research behind it , still prescribes them . This is not only wrong, it is dangerous. No joke! My partner is on surgery # 18 after Cipro… Damage is not rare, it is just delayed & Drs are not up to speed on new info. See FQ articles in Consumer Reports (2016), Newsweek, The Military Times, NY Times…Bet your Dr hasn’t read them!

    • Hi Barbara,
      Thank you for posting, sorry to hear your family has been affected. Here is a post about Cipro, see if you could anything else. And yes, you are absolutely right about lack of information among primary care physicians on this topic.


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