From the Guidelines
For men with urinary tract infections (UTIs), the recommended oral antibiotic treatment is Trimethoprim-sulfamethoxazole at a dose of 160/800 mg twice daily for 7 days, as suggested by the European Association of Urology guidelines 1. When considering treatment options for men with UTIs, it's essential to note that the treatment duration is generally longer than for women due to the potential for complicated infections. The European Association of Urology guidelines provide a clear recommendation for the treatment of UTIs in men, which includes Trimethoprim-sulfamethoxazole as a first-line option 1. Some key points to consider when treating men with UTIs include:
- The importance of completing the entire antibiotic course, even if symptoms improve quickly
- Drinking plenty of water to help flush bacteria from the system
- Seeking medical attention if symptoms worsen or don't improve within 48 hours of starting antibiotics
- The potential for underlying issues, such as prostate enlargement or kidney stones, that may require additional evaluation It's also worth noting that fluoroquinolones can be prescribed as an alternative, in accordance with local susceptibility testing, as mentioned in the guidelines 1. However, Trimethoprim-sulfamethoxazole remains the recommended first-line treatment for men with UTIs, due to its efficacy and safety profile, as supported by the most recent guidelines 1.
From the FDA Drug Label
Ciprofloxacin is indicated for the treatment of complicated urinary tract infections and pyelonephritis due to Escherichia coli The FDA drug label does not answer the question for men specifically, but ciprofloxacin is indicated for the treatment of complicated urinary tract infections and pyelonephritis due to Escherichia coli 2.
- Ciprofloxacin is a possible treatment option for UTIs.
- However, the label does not provide specific information about the use of ciprofloxacin in men with UTIs.
- The label does mention that ciprofloxacin is effective in treating complicated urinary tract infections and pyelonephritis in the general population, but it does not provide specific guidance for men 2.
- It is essential to consult a healthcare professional for proper diagnosis and treatment of UTIs in men.
From the Research
Oral Antibiotics for UTI in Men
- The first-line antibiotics for men with uncomplicated UTI include trimethoprim, trimethoprim/sulfamethoxazole, and nitrofurantoin for seven days 3.
- Men with lower UTI symptoms should always receive antibiotics, with urine culture and susceptibility results guiding the antibiotic choice 3.
- Clinicians should also consider the possibility of urethritis and prostatitis in men with UTI symptoms 3.
Treatment Options
- Fluoroquinolones were compared in two RCTs: lomefloxacin with norfloxacin, and ciprofloxacin for 7 days and 14 days 4.
- Of the 59 patients receiving a fluoroquinolone, 57 (97%) reported bacteriological and clinical cure within 2 weeks after treatment 4.
- The evidence available is insufficient to make any recommendations in relation to type and duration of antimicrobial treatment for male UTIs 4.
Antibiotic Resistance
- High rates of resistance for trimethoprim-sulfamethoxazole and ciprofloxacin preclude their use as empiric treatment of UTIs in several communities 5.
- Current treatment options for UTIs due to AmpC- β -lactamase-producing Enterobacteriales include nitrofurantoin, fosfomycin, pivmecillinam, fluoroquinolones, cefepime, piperacillin-tazobactam and carbapenems 5.
- Treatment oral options for UTIs due to ESBLs-E coli include nitrofurantoin, fosfomycin, pivmecillinam, amoxicillin-clavulanate, finafloxacin, and sitafloxacin 5.
Historical Context
- Sulfonamides, trimethoprim-sulfamethoxazole, nitrofurantoin, and nalidixic acid are excreted in the urine in high concentration and are active in vitro against usual aerobic gram-negative bacteria 6.
- Trimethoprim-sulfamethoxazole is a very effective combination agent in vitro, has appealing pharmacokinetic properties, and is usually well tolerated by patients 6.