What are the considerations for antibiotic therapy used to treat urinary tract infection (UTI) in males?

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

Because of antimicrobial-resistant N gonorrhoeae, it is important to carefully review relevant clinical history of the patient and precisely determine the etiology of urinary symptoms in males. If gonorrhea is suspected, a fluoroquinolone antibiotic should not be prescribed because of widespread fluoroquinolone resistance to N gonorrhoeae. Dual therapy with ceftriaxone IM/IV plus azithromycin PO is recommended by the CDC sexually transmitted diseases treatment guidelines. [27]  

There appears to be no advantage to treating UTI for more than 7 days in males without complications of urologic abnormalities, immunosuppression, clinical prostatitis, pyelonephritis nephrolithiasis, and/or BPH. [28]

Fifty-four percent of Enterobacteriaceae UTIs with resistance to extended-spectrum cephalosporin recurred within a median time of 69 days. [29]


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