Does azithromycin for uti work?

Posted on  December 31, 2020, Edited by Jason, Category  

Azithromycin for uti has a certain therapeutic effect on urinary tract infections, but many patients do not know enough about urinary infections, nor do they understand the efficacy of Azithromycin. Now I will answer these questions below.

What is azithromycin?

Azithromycin tablets, the indications for this product are suitable for the following infections caused by sensitive bacteria: bronchitis, pneumonia and other lower respiratory tract infections; skin and soft tissue infections; acute otitis media; sinusitis, pharyngitis, tonsillitis and other upper respiratory tract infections Azithromycin can effectively eliminate oropharyngeal Streptococcus, but there is no data on the efficacy of Azithromycin in the treatment and prevention of rheumatic fever.

Azithromycin can be used for simple genital infections caused by Chlamydia trachomatis in sexually transmitted diseases of men and women. Azithromycin can also be used for simple genital infections caused by non-multi-drug resistant Neisseria gonorrhoeae and chancroid caused by Haemophilus duke.


Whats a UTI?

1. Definition

Urinary tract infection (UTI) refers to pathogens that directly invade the urinary tract, grow and multiply in the urine, and invade the urinary tract mucosa or tissues to cause damage. According to the different parts of the pathogen's invasion, it is divided into pyelonephritis, cystitis, and urethritis.

Pyelonephritis is also called upper urinary tract infection, while cystitis and urethritis are collectively called lower urinary tract infection. Because the infection is rarely limited to a certain part of the urinary tract during childhood, and it is difficult to locate it clinically, it is often referred to as UTI without distinction. According to the clinical symptoms, it can be divided into symptomatic urinary tract infection (UTI) and asymptomatic bacteriuria.

According to a national survey conducted in China in 1982, urinary tract infections accounted for 8.5% of the diseases in this system. In 1987, according to statistics of children’s urine screening in 21 provinces and cities across the country, UTI accounted for 12.5% ​​of children’s urinary attacks. Whether adults or children, the incidence of female UTIs is generally higher than that of men, but the incidence of men is higher than that of women in newborns or early infants.

2. UTI Symptoms

A. Acute infection

  • Newborns. Mainly systemic symptoms, mostly caused by blood infection. It is accompanied by jaundice, occult bacteriuria, fever, lack of body temperature, pale skin, lack of weight gain, refusal of milk, diarrhea, lethargy and convulsions.
  • In infants and young children, the systemic symptoms are severe, mainly abdominal pain, diarrhea, and vomiting. Crying and foul-smelling urine appear during urination. Frequent urination can cause refractory diaper dermatitis. Enuresis appears at night without enuresis at the beginning.
  • In children, the symptoms of lower urinary tract infection are mainly bladder irritation, and upper urinary tract infections are presented as fever, chills, low back pain, percussive pain in the kidney area, and tenderness of the costal ridge angle. Hemorrhagic cystitis caused by Escherichia coli may have hematuria.

B. Recurrence and reinfection

Relapse means that bacteriuria becomes negative temporarily after treatment, and the original pathogenic bacteria reappears within a short period of time (6 weeks) after stopping the drug, and the symptoms reappear. Re-infection refers to an infection that has been cured after treatment and is caused by another pathogen invading the urinary tract for a long time (usually 6 weeks) after stopping the drug.

C. Chronic infection

The course of the disease is more than 6 months. Pyuria or bacteriuria may occur intermittently. People with a long course of disease may have anemia, fatigue, and developmental delay.

3. Causes of UIT

Any pathogenic bacteria can cause UTI, but most of them are Gram-negative bacilli, such as Escherichia coli, Para Escherichia coli, Proteus, Klebsiella, Pseudomonas aeruginosa, and a few are Enterococcus and Staphylococcus. Escherichia coli is the most common pathogen in UTI, about 60%-80%. For newborns suffering from UTI for the first time, girls of all ages and boys under one-year-old, the main pathogen is still Escherichia coli, while in boys over one-year-old, the main pathogen is mostly Proteus. For girls aged 10-16, Staphylococcus albicans is also common, and Klebsiella and Enterococcus are more common in newborns.

4. UTI Treatment

The purpose of treatment is to control symptoms, eradicate pathogens, remove predisposing factors, and prevent recurrence.

Principles for choosing antibiotics:

  • Site of infection: For pyelonephritis, drugs with high blood concentration should be selected, and drugs with high urine concentration should be selected for cystitis.
  • Path of infection: For ascending infections, sulfa drugs are the first choice. If systemic symptoms such as fever are obvious or blood-borne infections are detected, penicillins, aminoglycosides or cephalosporins are usually used alone or in combination.
  • Select antibiotics based on urine culture and drug sensitivity test results, combining with clinical efficacy.
  • The drug should have a high concentration in kidney tissue, urine, and blood.
  • The selected drugs have strong antibacterial ability and a broad antibacterial spectrum. It is best to use powerful and not-easy-to-produce-resistant-bacteria drugs.
  • Drugs with little damage to kidney function.

Azithromycin for UTI

Azithromycin is a new generation of macrolide antibiotics. Its antibacterial spectrum is wider than erythromycin. It has stronger antibacterial effect on gram-negative bacteria such as Neisseria gonorrhoeae than erythromycin. It also has a strong effect on Chlamydia trachomatis and Ureaplasma urealyticum. If you drink milk at home, Ballya can also do macrolides test to let you know if there are macrolides residues in the milk you drink.

Azithromycin is well absorbed orally, with a high concentration in tissues, a long half-life (2 to 3 days), and a high concentration in urogenital tract, prostate and other tissues. Therefore, it is commonly used clinically to treat Neisseria gonorrhoeae, Chlamydia trachomatis and Urea Urogenital infection caused by the original body.

Azithromycin tablets are used to treat infectious diseases. Normally, the symptoms will be eliminated after three consecutive days, and strengthened in next three days. The course of treatment and method of use are as follows: disperse in water and swallow it orally.

Adults: For sexually transmitted diseases caused by Chlamydia trachomatis or Neisseria gonorrhoeae, only 1.0g of this product needs to be taken orally once. Treatment of other infections: the total dose is 1.5g, divided into three doses; 0.5g of this product is taken once a day. Or the total dose is the same, still 1.5g, take 0.5g on the first day, then take 0.25g of this product once a day from the second to the fifth day.

The patient suffering from urinary tract infection should be treated in time, but pay attention to the medication under the guidance of a doctor, and do not use medication without authorization, which may endanger health. Drink plenty of water and flush the urethra to relieve the condition.

However, some doctors suggest that azithromycin is not effective in treating urinary tract infections. It is best to eat cephalosporins and levofloxacin. If you are unwell, you should go to the hospital to check your urine routine and follow your doctor's advice. Always drink plenty of water and urinate more.


Other Antibiotics for UTI

The following oral antibiotics are commonly used to treat simple UTI infections (acute cystitis): nitrofurantoin, fosfomycin, sulfamethoxazole-trimethoprim. Doctors should choose antibiotics based on the patient's medical history, UTI type, local drug resistance data, and cost. The first-line drugs are usually selected from nitrofurantoin, fosfomycin, and sulfamethoxazole-trimethoprim. When first-line drugs cannot be used, amoxicillin/clavulanic acid and certain cephalosporins such as cefpodoxime, cefdinir or cefaclor can be used.

Fluoroquinolones, such as ciprofloxacin and levofloxacin, are also commonly used for simple UTI. However, the FDA (U.S. Food and Drug Administration) strongly recommends that such drugs be used for more serious infections and should only be used when conventional antibiotics are not available.

A safety review by the FDA found that oral and injectable fluoroquinolones (also called "quinolones") are associated with serious and potentially disabling side effects, involving tendons, muscles, joints, nerves, and the central nervous system. These adverse reactions can occur shortly after administration to several weeks after exposure, and may be permanent.

Certain oral fluoroquinolones may be suitable for more complex urinary tract infections, including pyelonephritis and complex UTI with prostate involvement. For outpatient treatment of simple pyelonephritis, the following quinolones can be used: ciprofloxacin and levofloxacin. Depending on the resistance model (>10%), an initial dose of long-acting parenteral antibacterial drugs (such as ceftriaxone) or a 24-hour dose of aminoglycoside drugs may be required.

Ampicillin and amoxicillin, which are used to treat cystitis (E. coli infection), have high rates of antibiotic resistance. Other oral drugs with increased resistance rates include sulfamethoxazole and trimethoprim and fluoroquinolones. The resistance rate of oral cephalosporins and amoxicillin/clavulanate potassium is usually less than 10%, and amoxicillin/clavulanate potassium can still be used as a medication option.

What about frequent recurrence of urinary tract infections? Within one year of the onset of urinary tract infections, about 1/4 to 1/2 of women may be infected with UTI again. For such women, it is recommended to use antibiotics prophylactically, and perform urine culture or imaging tests for further analysis. Antibiotic selection should be based on previous urinary tract infections, drug availability, and patient factors (such as antibiotic allergy and cost). Antibiotics commonly used for recurrent UTI include sulfamethoxazole-trimethoprim, nitrofurantoin, cefaclor or cephalexin.

For postmenopausal women with recurrent urinary tract infections caused by vaginal dryness, vaginal estrogen can be used as an effective treatment. Recommended treatment options include: estrogen vaginal ring, vaginal tablet insert, or vaginal estrogen cream.

UTI treatment without antibiotics is generally not recommended. Early urinary tract infections (such as cystitis) may worsen over time, leading to more serious kidney infections (pyelonephritis). If you have symptoms of urinary tract infection, it is best to seek medical attention. If pregnant women suspect that they have a urinary tract infection, they should seek medical attention as soon as possible, otherwise the risk of delivering a low birth weight or premature baby may be greater.

Some patients may use cranberry or cranberry juice as a home remedy for urinary tract infections. However, cranberry juice for uti has not been proven to cure bacterial infections in the bladder or kidneys. In most cases, antibiotics are the best treatment for urinary tract infections. Based on limited data, increasing fluid intake (such as water), avoiding spermicide and urinating after intercourse can also help prevent UTI.

How to prevent UTI?

  • Keep the vulva clean. Adults should wash their vulva once a day, change their underwear frequently, wipe the anus after bowel movements, and avoid bringing dirt from the anus to the urethral opening.
  • Pay attention to sexual hygiene. Before sex, the external genitalia should be cleaned. If contraceptives are used, they should be cleaned or disinfected. You should urinate once before and after sex. In addition, quit masturbation, especially masturbation with utensils, to prevent urinary tract infection and injury.
  • Prevent full urine. When you have a desire to urinate, urinate in time, do not hold back your urine, and empty your bladder every night before going to bed.
  • Eliminate invading germs. Drink plenty of boiled water to increase urine output, so that the urine will continue to flush the urinary tract, expel bacteria and toxins as soon as possible, and keep the urinary tract clean.
  • Strengthening physical fitness is an important aspect to prevent urinary tract infections.

Strengthening physical fitness is an important aspect to prevent urinary tract infections.


Azithromycin for uti is effective, but its effectiveness may not be as magical as we thought. And azithromycin belongs to the macrolide antibiotics, so its side effects are serious. In the event of UTI, you should seek medical attention in time and take antibiotics recommended by your doctor.


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