Pharmacology of Drugs for Urinary Tract Infections (UTIs)

Pharmacology of Drugs for Urinary Tract Infections explains mechanisms of drugs used to treat bacterial infections of the urinary tract

Pharmacology of Drugs for Urinary Tract Infections (UTIs)

1. First-Line Antibiotics (Uncomplicated UTI)

   1. Nitrofurantoin

      • Mechanism: Damages bacterial DNA
      • Use: Cystitis (not for pyelonephritis)
      • Note: Avoid in renal impairment

   2. Fosfomycin

      • Mechanism: Inhibits bacterial cell wall synthesis
      • Use: Single-dose treatment for uncomplicated UTI

   3. Trimethoprim-Sulfamethoxazole (TMP-SMX)

      • Mechanism: Inhibits folate synthesis
      • Use: Acute cystitis, but resistance is rising

2. Fluoroquinolones

   • Examples: Ciprofloxacin, Levofloxacin
   • Mechanism: Inhibit DNA gyrase & topoisomerase IV
   • Use: Pyelonephritis, complicated UTI
   • Caution: Tendon rupture, QT prolongation; avoid overuse

3. Beta-Lactams

   • Examples: Amoxicillin-clavulanate, Cefixime
   • Use: Alternative in pregnancy or resistant infections

Adjunctive Agents

• Urinary antiseptics: Methenamine (used in long-term prophylaxis)
• Alkalizers: Sodium citrate – used to relieve dysuria

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