From the Guidelines
Antibiotics such as trimethoprim-sulfamethoxazole (TMP-SMX), nitrofurantoin, and fosfomycin, which are commonly used to treat Urinary Tract Infections (UTIs), can increase the risk of vulvovaginal candidiasis (yeast infections) due to their broad-spectrum effects on bacterial flora. These medications, as recommended by the American Urological Association (AUA) guidelines 1, are effective in treating UTIs but can disrupt the natural balance of vaginal flora, leading to an overgrowth of Candida albicans. When considering treatment options for UTIs, it is essential to weigh the benefits of antibiotic therapy against the potential risks of collateral damage, including the development of yeast infections 1. Some key points to consider when treating UTIs and reducing the risk of yeast infections include:
- Using first-line therapies such as nitrofurantoin, TMP-SMX, or fosfomycin, which are less likely to produce collateral damage compared to second-line agents 1
- Treating UTIs with as short a duration of antibiotics as reasonable, generally no longer than seven days, to minimize disruption to the natural flora 1
- Considering the use of probiotics, particularly those containing Lactobacillus, during and after antibiotic treatment to help maintain a healthy balance of vaginal flora
- Practicing good hygiene, wearing cotton underwear, and avoiding douches or scented feminine products to reduce the risk of yeast infections If symptoms of a yeast infection develop during antibiotic treatment, such as itching, burning, unusual discharge, or redness, it is crucial to contact a healthcare provider for guidance on antifungal treatment options, such as fluconazole (Diflucan) or topical treatments, while continuing the antibiotic course to properly treat the UTI.