What are the medications for dysuria (painful urination)?

From the Guidelines

Medications for dysuria typically include antibiotics for bacterial infections, pain relievers, and treatments for underlying conditions, with first-line antibiotics being nitrofurantoin, trimethoprim-sulfamethoxazole, or fosfomycin, as recommended by the most recent guidelines 1.

Treatment Options

For urinary tract infections (UTIs), the following antibiotics are recommended:

• Nitrofurantoin (Macrobid) 100mg twice daily for 5-7 days
• Trimethoprim-sulfamethoxazole (Bactrim) 160/800mg twice daily for 3 days
• Fosfomycin (Monurol) as a single 3g dose These antibiotics are effective in eliminating the infectious cause of dysuria, as supported by the guidelines 1.

Pain Relief

For pain relief, the following options are available:

• Phenazopyridine (Pyridium) 200mg three times daily for 2 days, which provides temporary symptom relief while antibiotics take effect
• Nonsteroidal anti-inflammatory drugs like ibuprofen 400mg every 6-8 hours, which can help reduce discomfort

Underlying Conditions

For dysuria caused by vaginal infections, antifungals like fluconazole 150mg as a single dose may be appropriate, as mentioned in the guidelines 1.

Additional Recommendations

Increased fluid intake is recommended to help flush bacteria from the urinary tract, as suggested by the guidelines 1. It's essential to complete the full course of antibiotics even if symptoms improve to prevent recurrence and antibiotic resistance, as emphasized by the guidelines 1.

Key Considerations

When choosing an antibiotic, it's crucial to consider the patient's allergy history, local resistance patterns, and the potential for collateral damage, as discussed in the guidelines 1. The choice of antibiotic should be individualized and based on patient-specific factors, as recommended by the guidelines 1.

From the FDA Drug Label

Urinary Tract Infections and Shigellosis in Adults and Pediatric Patients, and Acute Otitis Media in Children Adults: The usual adult dosage in the treatment of urinary tract infections is 1 sulfamethoxazole and trimethoprim DS tablet every 12 hours for 10 to 14 days Children: The recommended dose for children with urinary tract infections or acute otitis media is 40 mg/kg sulfamethoxazole and 8 mg/kg trimethoprim per 24 hours, given in two divided doses every 12 hours for 10 days.

The medications for dysuria (painful urination) are:

• Trimethoprim-sulfamethoxazole (PO): The usual adult dosage is 1 DS tablet every 12 hours for 10 to 14 days 2
• Amoxicillin-clavulanate (PO): Used for complicated urinary tract infections, with a dosage of 875 mg/125 mg every 12 hours for 14 days 3

From the Research

Medications for Dysuria

The following medications are used to treat dysuria (painful urination) caused by urinary tract infections (UTIs):

• Nitrofurantoin: a first-line antibiotic for treating uncomplicated UTIs in women and men 4, 5
• Fosfomycin: a single-dose antibiotic for treating uncomplicated UTIs in women 4, 6, 5
• Trimethoprim/sulfamethoxazole: a first-line antibiotic for treating uncomplicated UTIs in women and men, although its use may be limited by resistance 4, 6, 5, 7, 8
• Trimethoprim: a first-line antibiotic for treating uncomplicated UTIs in men 4
• Fluoroquinolones: an option for treating uncomplicated UTIs, although their use may be limited by resistance 5, 7
• Beta-lactam antibiotics: not recommended for initial treatment of uncomplicated UTIs due to concerns about resistance 6
• Methenamine hippurate: may be used to prevent recurrent UTIs 4
• Nonsteroidal anti-inflammatory drugs: may be used for symptomatic treatment of UTIs 4

Treatment Duration

The duration of treatment for uncomplicated UTIs varies:

• Nitrofurantoin: 5 days for women, 7 days for men 4
• Fosfomycin: single dose 4, 6, 5
• Trimethoprim/sulfamethoxazole: 3 days for women, 7 days for men 4
• Trimethoprim: 3 days for women, 7 days for men 4

Special Considerations

• Men with lower UTI symptoms should always receive antibiotics, with urine culture and susceptibility results guiding the antibiotic choice 4
• Women with recurrent infections, treatment failure, history of resistant isolates, or atypical presentation should have urine culture and susceptibility testing to guide antibiotic selection 4
• Increased fluids, intake of cranberry products, and methenamine hippurate may help prevent recurrent infections 4