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.

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.

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: February 20, 2019