Pregnancy RecommendationsAntibiotics for UTI

Pregnancy Recommendations: Antibiotics for UTI

UTI or urinary tract urinary infection is a common condition experienced in pregnancy. During pregnancy, physiological changes to the urinary tract increase the risk of urinary infection.  Some changes may include decreased bladder capacity and dilation of the urethra. UTI is an umbrella term that defines infection of the kidneys, bladder, or urethra. Common signs and symptoms may include:

  • Feeling unwell
  • Cloudy looking urine or urine that has blood
  • A strong smell of urine
  • Lower abdominal pain
  • Increased frequency of urination
  • Difficulties when urination

On the other hand, asymptomatic bacteriuria is also possible during pregnancy. It is defined as the presence of bacteria in the urine with no symptoms of UTI. It is recommended to test for bacteria before any treatment with certain antibiotics for UTI in pregnancy. Test for bacteria presence is usually performed by obtaining a midstream urine sample.

Recommendation for Asymptomatic Bacteriuria in Pregnancy

The recommendation for treatment of ABS in pregnancy follows the same choice of antibiotic selection as the management of UTI discussed. Main antibiotics used include:

  • Nitrofurantoin
  • Cefalexin
  • Amoxicillin (when urine test confirms suitability)

Recommended Antibiotics during Pregnancy for UTI

1. Nitrofurantoin

Nitrofurantoin is recommended as the first-line treatment for UTI during pregnancy. This medicine is usually prescribed in the form of a modified-release capsule to be taken twice a day for 7 days. Always check for the prescriber’s directions on the recommended dosage and the length of the treatment.

Product data for Nitrofurantoin approves the long-term use of this antibiotic since 1952 and its appropriateness as a treatment choice in pregnancy is well documented. This medicine should be prevented at term in the pregnancy, during labor, and delivery of the baby. Also, Nitrofurantoin is usually well-tolerated, but as with many other medications, there is a possibility of side effects. Possible side effects may include:

  • Abdominal pain
  • Upset stomach
  • Nausea
  • Diarrhea
  • Yellow or brown discoloration of urine

2. Cefalexin

Cefalexin is usually taken at the dosage of 500 mg twice a day for 7 days. Follow the instructions of your prescriber on the dosage and treatment. Common side effects associated with the use of this medicine may include:

  • Diarrhea
  • Nausea
  • Feeling sick

3. Amoxicillin

Amoxicillin is recommended as a second-line treatment for UTI during pregnancy. It is only if bacterial test results approve that this antibiotic is an effective treatment. This medication is usually taken 3 times a day for 7 days. Follow the directions of your doctor for dosage instructions and the length of the treatment. Common side effects which can be experienced by patients while taking Amoxicillin may include:

  • Feeling sick
  • Diarrhea
  • Nausea

Other Advice for Management of UTI when Pregnant

  • Pregnant patients with UTI must maintain a good intake of fluids to prevent dehydration.
  • Pregnant women should seek an immediate medical assessment if symptoms get worse at any time or when the condition fails to improve 48 hours after starting antibiotics.
  • Take certain supplements such as vitamin C, probiotics, or cranberries. These may help treat recurrent UTIs in women. However, it is important to seek medical advice before taking any supplements especially if you are pregnant.

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