How is urinary tract infection (UTI) in males treated?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Initial inpatient treatment includes the following:

  • Intravenous (IV) antimicrobial therapy with a third-generation cephalosporin (eg, ceftriaxone, ceftazidime), a fluoroquinolone (eg, ciprofloxacin, levofloxacin, ofloxacin, norfloxacin), or an aminoglycoside (eg, gentamicin, tobramycin) (beware ototoxicity)

  • Antipyretics

  • Analgesics

  • IV fluid resuscitation: To restore appropriate circulatory volume and promote adequate urinary flow

Other medications used in the management of male UTIs—or etiologic conditions such as prostatitis; epididymitis; pyelonephritis; or cystitis/urethritis—include the following:

  • Antibiotics such as trimethoprim, trimethoprim-sulfamethoxazole, ampicillin, amoxicillin, ertapenem, erythromycin, vancomycin, doxycycline, aztreonam, nitrofurantoin, rifampin

  • Urinary analgesics such as phenazopyridine

Broaden the antimicrobial coverage and add an antipseudomonal agent in patients with risk factors associated with an unfavorable prognosis (eg, old age, debility, renal calculi, recent hospitalization or instrumentation, diabetes, sickle cell anemia, underlying carcinoma, or intercurrent cancer chemotherapy).


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