A urinary tract infection (UTI) is an infection that can occur in any part of the urinary system, including the urethra, bladder, ureters or kidneys. However, it most commonly develops as urethritis, an infection of the urethra (the tube that transports urine from the bladder out of the body). Unless otherwise noted, all mentions of UTI below refer to urethritis.
Because women have a shorter urethra and because their urethra is in close proximity to the anus, they are more susceptible to UTIs. During pregnancy, as hormone fluctuations and an expanding uterus cause changes to the urinary tract, their risk of developing a UTI is even higher. Treatments for urinary tract infections during pregnancy include antibiotic medications to battle the bacteria and increased hygiene for prevention.
Self-Care Treatment for Urinary Tract Infection during Pregnancy
Hormonal changes during pregnancy increase urine concentration, while changes to the urinary tract--caused by the expanding uterus--reduce urine output. Stagnant urine allows concentrated populations of bacteria to multiply and cause a urinary tract infection. Drinking plenty of water can not only prevent UTIs but can help treat them, as it increases urine volume and allows the body to flush out harmful bacteria.
Medications for the Treatment of Urinary Tract Infection during Pregnancy
Antibiotic medications are frequently used to treat urinary tract infections in women who are pregnant. They are typically prescribed for three to 10 days, depending on the type of medication and the severity of the infection. Common antibiotics that have been approved for the treatment of urinary tract infections during pregnancy include:
- Penicillins: Penicillins, including amoxicillin, were once the principle treatment of choice for urinary tract infections, but are ineffective against E. coli-driven UTIs in up to 30 percent of cases. They are, however, useful against urinary tract infections caused by other bacteria, such as Staphylococcus saprophyticus or Enterococcus. Stubborn, drug-resistant infections may have to be addressed with Augmentin (a combination of amoxicillin and clavulanate). Penicillins are typically prescribed for 10 days and are generally well tolerated by most patients. Side effects include diarrhea, nausea, stomach pain, and vaginal itching or discharge.
- Cephalosporins: Cephalosporins include medications such as cephalexin (Keflex), cefuroxime (Ceftin) and cefadrozil (Duricef). These antibiotics are currently the most widely prescribed medications for UTIs, but can only be used in the first and second trimesters. Because of their potency, cephalosporins are usually prescribed for three to seven days and are well tolerated. Side effects of these medications include upset stomach, nausea, vomiting, and diarrhea.
- Fluoroquinolones: Fluoroquinolones, including norfloxacin and ciprofloxacin, are typically used as a second line of defense for the treatment of urinary tract infections if other medications have failed. These medications are effective for severe infections, but often have more side effects than other antibiotics. They should be avoided during during the first trimester, but can be used during the second or third trimester if all other alternatives have been exhausted. Side effects of fluoroquinolones include moderate to severe nausea and vomiting, diarrhea, headache, dizziness, and photosensitivity.
- Nitrofurantoin: Nitrofurantoin, including Furadantin and Macrodantin, can be used with some limitations. This medication--usually taken for seven to 10 days--should not be given to women within two weeks of delivery due to concerns that it may cause anemia in the newborn. Nitrofurantoin has a number of drug interactions and is not recommended for patients receiving treatment for kidney disease. Side effects include upset stomach, nausea, vomiting, mild diarrhea, vaginal itching or discharge, and brownish urine.
Other Medications for the Treatment of UTI during Pregnancy
Other medications may also be helpful in treating the symptoms of a urinary tract infection. In particular, phenazopyridine (Pyridium) can be used to treat the pain and burning associated with a urinary tract infection. Although safe for use during pregnancy, it should not be taken for more than two days. Side effects include headache, stomach upset, and dark orange or red urine.
References
Urinary tract infection—Medications. (2011). University of Maryland Medical Center.
Lee, M., Bozzo, P., Einarson, A., & Koren, G. (2008). Urinary tract infections in pregnancy. Canadian Family Physician. 54(6):853-854.
Delzell, J.E., & Lefevre, M.L. (2000). Urinary Tract Infections During Pregnancy. Am Fam Physician. 61(3):713-720.
