From the Guidelines
For male UTIs, the recommended antibiotics include fluoroquinolones (5 to 7 days) or trimethoprim-sulfamethoxazole (TMP-SMZ) (14 days) based on antibiotic susceptibility, as suggested by the American College of Physicians 1.
Key Considerations
- Uncomplicated pyelonephritis in men can be treated with short-course therapy using fluoroquinolones or TMP-SMZ, with the choice of antibiotic depending on the susceptibility of the causative organism 1.
- The duration of treatment for uncomplicated pyelonephritis in men is typically 5 to 7 days for fluoroquinolones or 14 days for TMP-SMZ 1.
- It is essential to obtain a urine culture to identify the specific bacteria causing the infection and ensure appropriate antibiotic selection 1.
- Men with UTI symptoms should seek prompt medical attention, as male UTIs are less common than in women and may indicate underlying issues like prostate problems or structural abnormalities 1.
Treatment Options
- Fluoroquinolones (5 to 7 days): effective against a wide range of bacteria, including E. coli, which is the most common cause of UTIs in men 1.
- Trimethoprim-sulfamethoxazole (TMP-SMZ) (14 days): an alternative option for men with uncomplicated pyelonephritis, although its use may be limited by resistance patterns 1.
Important Notes
- Increased fluid intake, particularly water, can help flush bacteria from the urinary tract and support the recovery process 1.
- Men should complete the entire prescribed course of antibiotics, even if symptoms improve quickly, to prevent recurrence and ensure complete eradication of the infection 1.
From the FDA Drug Label
Levofloxacin tablets are indicated for the treatment of complicated urinary tract infections due to Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis Levofloxacin tablets are indicated for the treatment of uncomplicated urinary tract infections (mild to moderate) due to Escherichia coli, Klebsiella pneumoniae, or Staphylococcus saprophyticus. Levofloxacin tablets are indicated for the treatment of chronic bacterial prostatitis due to Escherichia coli, Enterococcus faecalis, or methicillin-susceptible Staphylococcus epidermidis
Levofloxacin can be used to treat male UTI in the following cases:
- Complicated urinary tract infections due to Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis
- Uncomplicated urinary tract infections due to Escherichia coli, Klebsiella pneumoniae, or Staphylococcus saprophyticus
- Chronic bacterial prostatitis due to Escherichia coli, Enterococcus faecalis, or methicillin-susceptible Staphylococcus epidermidis 2
From the Research
Antibiotics for Male UTI
- The optimal approach for treating male urinary tract infections (UTIs) is unclear, but several studies have investigated the effectiveness of different antibiotics and treatment durations 3, 4.
- A systematic review of randomized controlled trials found that fluoroquinolones were effective in treating male UTIs, with 97% of patients achieving bacteriological and clinical cure within 2 weeks of treatment 3.
- However, the evidence available is insufficient to make recommendations on the type and duration of antimicrobial treatment for male UTIs, and further studies are needed 3.
- A study of outpatient male UTIs found that fluoroquinolones were the most commonly prescribed antibiotics, followed by trimethoprim-sulfamethoxazole, nitrofurantoin, and beta-lactams 4.
- The same study found that longer treatment duration was not significantly associated with UTI recurrence, and that men with UTI without complicating conditions may not need to be treated for longer than 7 days 4.
- Other studies have investigated the use of different antibiotics for UTIs, including sulfonamides, trimethoprim-sulfamethoxazole, nitrofurantoin, and nalidixic acid 5, 6, 7.
- These studies suggest that the choice of antibiotic should be based on individual patient factors, such as the presence of complicating conditions and the susceptibility of the infecting organism to different antibiotics 5, 6, 7.
Treatment Options
- Fluoroquinolones, such as ciprofloxacin and lomefloxacin, are effective in treating male UTIs 3.
- Trimethoprim-sulfamethoxazole is also effective, but may not be suitable for patients with certain complicating conditions 5, 4.
- Nitrofurantoin and beta-lactams, such as amoxicillin-clavulanate, may be alternative options for patients who cannot tolerate fluoroquinolones or trimethoprim-sulfamethoxazole 5, 4.
- Sulfonamides, such as sulfamethoxazole, may be considered for patients with uncomplicated lower urinary tract infections 7.
Treatment Duration
- The optimal treatment duration for male UTIs is unclear, but studies suggest that 7 days may be sufficient for patients without complicating conditions 4.
- Longer treatment durations may be necessary for patients with complicating conditions, such as prostatitis or pyelonephritis 4.
- Further studies are needed to determine the optimal treatment duration for male UTIs 3, 4.