What is the recommended treatment for strep (Streptococcus) agalactiae urinary tract infection (UTI)?

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Last updated: June 17, 2025View editorial policy

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From the Research

The recommended treatment for Streptococcus agalactiae urinary tract infection is typically a course of penicillin, ampicillin, or amoxicillin for 5-7 days for uncomplicated cases, with dosages of amoxicillin typically at 500 mg three times daily or ampicillin 500 mg four times daily, as supported by the most recent study 1. This recommendation is based on the fact that Streptococcus agalactiae is naturally sensitive to penicillins, which inhibit cell wall synthesis in the bacteria.

  • The most recent study 1 found that all GBS strains were fully sensitive to penicillin, ampicillin, and vancomycin, making these antibiotics the best choice for treatment.
  • For patients with penicillin allergies, alternatives include cephalosporins like cefazolin or ceftriaxone, as suggested by earlier studies 2, 3.
  • It's essential to complete the full course of antibiotics even if symptoms improve before completion, and adequate hydration is also recommended during treatment.
  • Follow-up urine cultures may be necessary to confirm clearance of the infection, especially in pregnant women or patients with recurrent infections, as noted in study 4.
  • High resistance to clindamycin and tetracycline was observed in the most recent study 1, making these antibiotics less suitable for treatment.
  • The study 5 from 1982 found that amoxicillin was 2.5 times as active as ampicillin, but this information is less relevant given the more recent findings.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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