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Prophylactic Antibiotics for Urinary Tract Infection

Recurrent urinary tract infections (cystitis) are infections that occur two or more times within a six-month period or three or more times within one year. According to the American Academy of Family Physicians, as many as 20 percent of women who experience acute urinary tract infections will develop recurrent infections. To prevent frequent recurrences, your doctor may recommend a prophylactic antibiotic.

  1. Benefits

    • Avoiding the pain and discomfort associated with urinary tract infections (UTIs) and maintaining a feeling of well-being is a key benefit to taking prophylactic antibiotics. Additionally, according to the American Academy of Family Physicians, (UTIs) are a foremost cause of health-care expenses for people of all ages. In the United States alone, costs of UTI-related office visits and hospitalizations exceed $1 billion. Prophylactic antibiotics can lower overall health-care costs while improving the quality of life for women who suffer from recurrent infections.

    Daily Prophylactic Therapy

    • Low doses of certain antibiotics may be taken each day for a period of six months or longer. Taking the medication at night maximizes the benefits. Suggested dosages are as follows: Trimethoprim/sulfamethoxazole (TMP/SMZ), one-half tablet daily; norfloxacin, 200 mg daily; trimethoprim, 100 mg daily; cephalexin, 250 mg daily; and nitrofurantoin, 50 to 100 mg daily. According to research from the University of Washington, these medications are both effective and pose minimal risk of side effects.

    Taking Prophylactic Antibiotics After Sexual Intercourse

    • According to the American Academy of Family Physicians, sexually active young females are at the highest risk for developing urinary tract infections. Sexual activity, spermicide use or diaphragm use can contribute to this risk. Taking a prophylactic antibiotic after sexual intercourse may be effective if your UTIs have been linked to sexual activity. Half of a double-strength TMP/SMZ tablet is indicated for this purpose.

    Using Prophylactic Antibiotics as Self-Treatment

    • Both Medline Plus and the American Academy of Family Physicians indicate that taking a three-day course of antibiotics is effective when taken at the emergence of UTI symptoms. This may include TMP/SMZ (one tablet, two times per day); norfloxacin (400 mg, two times per day); trimethoprim (100 mg, two times per day); nitrofurnatoin (100 mg, four times per day), ciprofloxacin (250 mg, two times per day) or levofloxacin (250 mg, once daily).

    Is It Effective?

    • The Cochrane Collaboration studied a variety of clinical trials assessing the efficacy of antibiotics as prophylactic treatment of recurrent urinary tract infections. Out of 19 different studies, results indicated significant reduction in recurrent UTIs with continual use of prophylactic antibiotics for a period of six months to one year. Results also indicated prophylactic antibiotic usage has a positive effect on intercourse-related UTIs.

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