Which antibiotic for UTI?

[Rave]

I've forgotten which antibiotic works best for UTI's and vets are closed until Tuesday and none of my vet friends are around ATM. Anyone know? I'm thinking Cephalexin? Or hoping is more like it, since that's what I have the most of lying around. Thanks!

[PSmitty]

Cephalexin is what my dog was given last time for a UTI, if that helps any.

[Rave]

It does, thanks! I knew it was a broad-spectrum antibiotic, just wanted to make sure it was a the drug of choice of UTI's though.

[Mojo]

Actually, amoxicillin, trimethoprim sulfa, or a drug of the fluoroquinolone class (like Baytril) are actually the drugs of choice for the vast majority of urinary tract infections, since the most common organisms are E. coli, staphylococcus, and stretpococcus:

 

http://courses.vetmed.wsu.edu/vm552/urogen...2.htm#Treatment

 

The website indicates you have chosen to give a drug that is a type of cephalosporin, which is typically recommended for RESISTANT infections, or unusual organisms (like Klebsiella species). I know that you were in a bind by having this problem occur when the vets are closed for the weekend (and I've definitely been in this situation plenty of times with my kidney failure dog who always has chronic UTIs), but you should also recognize that by jumping to this class of drug without getting a urine culture and sensitivity first to see what you are dealing with, you may be setting yourself up for bacterial resistance later on. In order to avoid this, please make sure you finish the recommended time course....they say 14 days for a female, and FOUR WEEKS if it is a male. I'm sure you know this, but the best thing to do, even in the case of presumed uncomplicated UTIs (i.e., no involvement of the kidneys, no kidney stones), is always to get a urine C&S at the vet before you ever start an antibiotic. I know it is expensive, but that way you can make sure you are giving the right drug for the right infection...again, I see how that was impossible in this case, though. I assume that you have already given the first dose of Keflex, so the best thing to do now would be to keep going with the drug and then to get the C&S at the end of the course to confirm the infection has been cleared, or even sooner if the symptoms do not appear to be alleviating (as then it would be more likely that you have got the wrong drug). "Broad-spectrums" are great in that they get nearly all bugs, so your dog will likely be fine, as common infections (i.e., common species of bacteria that are non-resistant in a dog that does not have kidney problems) tend to be the most common, obviously, but as a general rule, broad-spectrum "big guns" are reserved for the most difficult infections, so that you will always have something left in your arsenal. I hope that helps...

 

ETA: the moral of the story is that there is not always ONE antibiotic that will work best in every situation, although there is a likelihood of what may or may not work, and in the absence of a culture (confirmed evidence of the type and presence of a bacterial infection), you can certainly guess at which antibiotic might do the job, as you have done here since the vets are closed, but the best thing to do is always to get a culture before you ever start the treatment.

[Guest TheRuffMuttGang]

I've always had really good luck pumping cranberry pills into dogs with UTIs. Cranberry lowers the PH of the urine thus making it an unsuitable environment for the bacteria.

[Rave]

I've had luck with Vitamin C as well for another dog who had high pH but no crystals.

 

Did finally get in touch with a vet friend and she agreed Cephalexin is the way to go since it has "nice high levels in the urine".

 

Most times I've brought dogs in with UTI's, they just sample the urine for crystals/infection, but don't culture it - just prescribe a general antibiotic. Never heard of a vet culturing on the first visit, interesting.

 

Thanks everyone.