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4. Antibiotics
Summary of antibiotics used in urinary tract infections
Class of antibiotics | Type of antibiotics | Mechanism of action | Commonly used names of antibiotics | Comments |
---|---|---|---|---|
Trimethoprim | Bacteriostatic | Inhibits bacterial thymidine synthesis | N/A | Being a folate antagonist, trimethoprim should not be prescribed for pregnant ladies who are in their first trimester |
Nitrofurantoin | Bacteriostatic | Believed to be inhibition of several bacterial enzymes involved in the synthesis of DNA, RNA and other bacterial metabolic enzymes | N/A | Not to be used in pregnant ladies who are in their third trimester as it may induce neonatal haemolysis. Risk of lung fibrosis and hepatotoxicity |
Penicillin | Bactericidal | Interferes with bacterial cell wall synthesis | Ampicillin Amoxicillin Flucloxacillin Penicillin V Benzylpenicillin Piperacillin | Contraindicated in patients who have hypersensitivity to penicillin. Encephalopathy is also another rare but serious side of penicillin |
Fluoroquinolones | Bactericidal | Inhibits DNA gyrase | Ciprofloxacin Levofloxacin Ofloxacin Moxifloxacin Norfloxacin | Contraindicated if patients have a history of tendon rupture or tendonitis |
Aminoglycoside | Bactericidal | Inhibits bacterial protein synthesis | Gentamicin Neomycin Amikacin Tobramycin Streptomycin | Well known side effects of this class of medication are ototoxicity and nephrotoxicity |
Fosfomycin | Bactericidal | Inhibits enzyme-catalyzed reaction in bacterial cell wall synthesis | N/A | |
Cephalosporin | Bactericidal | Disrupts bacterial cell wall synthesis | First generation: cefazolin, cephalexin Second generation: cefoxitin, cefaclor, cefuroxime Third generation: ceftriaxone, cefotaxime, ceftazidime Fourth generation: cefepime | About 0.5–6.5% of penicillin-sensitive/allergic patients will also be sensitive to cephalosporins |
Carbapenem | Bactericidal | Disrupts bacterial cell wall synthesis | Meropenem Ertapenem Imipenem Doripenem |
4.1 Trimethoprim
The dosage of trimethoprim to treat UTI is usually 200 mg BD.