Amoxicillin, Amoxicillin/Clavulanate for UTIs (Uncomplicated)

Based on "Principles and Practice of Infectious Diseases"
written by John E. Bennett, MD

Most Urinary Tract Infections (UTIs) represent acute uncomplicated cystitis (bladder infection).

Amoxicillin/clavulanate (Augmentin®)

Benefits

  • Amoxicillin/clavulanate is now regarded as a third-line treatment for UTI in preference to amoxicillin alone 1.
  • Amoxicillin/clavulanate is an appropriate choice for bladder infection when other recommended antibiotics cannot be used.
  • Good choice for bladder infections during pregnancy2.

Disadvantages

  • Amoxicillin-clavulanate is less effective than ciprofloxacin or levofloxacin.
  • Expensive.

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Amoxicillin/clavulanate dosage for UTI:
500/125 mg twice per day for 7 days.
875/125 mg twice per day for 7 days.


Amoxicillin

According to the latest Guidelines amoxicillin is no longer recommended for urinary tract infections because of resistance and higher recurrence rates1.

Benefits

  • Amoxicillin is FDA approved for UTIs.
  • Currently amoxicillin is not suitable as empiric therapy for cystitis but can be prescribed if urine culture shows susceptibility.
  • Amoxicillin reaches high urinary concentrations.
  • Inexpensive.
  • Safe to use during pregnancy.

Disadvantages

  • Most E. coli are now resistant to amoxicillin, so it is not good for empirical treatment.
  • Amoxicillin has a relatively poor efficacy.
  • Patients are more likely to developed recurrent infection after amoxicillin therapy than after first line medications.
  • Amoxicillin should NOT be used for UTIs in men because of great likelihood of deep tissue infection of the kidney or prostate.

Amoxicillin dosage for UTI: 250-500 mg 4 times daily for 7 days3.

Can Amoxicillin Treat UTI?

Yes, amoxicillin can treat bladder infection caused by susceptible bacteria. So, your doctor can prescribe amoxicillin if this antibiotic is appropriate in your case.

Is Amoxicillin a Good Choice for UTI?

Amoxicillin alone is not considered to be an effective treatment for UTI in the U.S. because of high resistance rates. Amoxicillin/clavulanate (Augmentin®) is more effective.

How Fast Does Amoxicillin Work?

The recommended duration of treatment is 7 days. You may notice improvement in symptoms in three days.

Further reading

References

  • 1. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103–e120.
  • 2. Delzell JE Jr, Lefevre ML. Urinary tract infections during pregnancy. Am Fam Physician. 2000 Feb 1;61(3):713-21. Available at American Academy of Family Physicians
  • 3. Amoxil® Prescribing Information PDF

Published: August 01, 2018 by eMedExpert staff
Last updated: August 01, 2018


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