div class=”ChapterContextInformation”>
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. 

Stay updated, free articles. Join our Telegram channel
 
				Full access? Get Clinical Tree
 
				 
	
				
			
		            
	         
