Male UTI Treatments May Miss the Mark

UTI treatment time for men does not lower chances of getting infection again

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Urinary tract infections (UTI) are more common in women than in men. But for men who have UTIs, poorly defined treatments can lead to antibiotic resistance and higher costs.

Although doctors often recommend men be treated at least seven days for these infections, being treated more than a week doesn't reduce their chances of having another UTI in the future, a new study has found.

"See your doctor if you have pain when urinating."

Pain accompanied with cloudy or bloody urine marks the urinary tract infection, which have been studied more often in women.

The study, led by Dimitri Drekonja, MD, from the Minneapolis Veterans Affairs Health Care System and assistant professor in the Department of Medicine at the University of Minnesota, included more than 30,000 male veterans with almost 40,000 episodes of a urinary tract infection in 2009.

Patients were about 68 years old on average. Researchers found male episodes of UTI through looking at the Veterans Affairs system and excluded those who were hospitalized for the UTI.

They grouped episodes based on when they happened. The first UTI case is called the index. New episodes of UTI that popped up again less than 30 days later were grouped among early recurrence cases and after 30 days were classified as late. Researchers tracked the drugs patients took to treat their UTI, how long they were treated and what happened to patients afterwards.

Researchers found that among the UTI cases, more than 85 percent were index cases, another 4.5 percent were early recurrences, and more than 10 percent were late recurrences.

As far as treatments, about 63 percent of patients took ciprofloxin, commonly known as Cipro, and about 27 percent took trimethoprim-sulfamethoxazole, also called Septra.

The majority of patients opted for the longer treatment with 65 percent taking medication longer than a week. The rest were treated less than seven days.

Having the longer treatment did not lower the number of early or late episodes of UTI; rather, the odds of having a late recurrence were slightly higher than those who were not treated as long, at almost 11 percent and 8 percent respectively.

"We found that two drugs were used to treat most male UTI episodes and that the treatment duration varied substantially within the recommended seven to 14 days and outside of this range," researchers said in a press release.

"Most important, compared with shorter-duration treatment, longer-duration treatment exhibited no association with a reduced risk for early or late recurrence."

The authors note that some of the UTI cases may have been identified incorrectly.

The study was published online December 3 in the Archives of Internal Medicine by the Journals of the American Medical Association. One of the authors received grants and contacts from Merck, Rochester Medical and Syntiron. The Center for Epidemiological and Clinical Research and the Center for Chronic Disease Outcomes Research funded the study.

Reviewed by: 
Review Date: 
December 6, 2012
Last Updated:
February 22, 2013