How Effective Is Doxycycline for a UTI?
Medically reviewed by Mary Choy, PharmD
Doxycycline is a tetracycline antibiotic that comes in oral and injectable forms. It’s available in several brand and generic versions, such as Vibramycin, Monodox, and Doryx.
If you suspect you have a urinary tract infection (UTI), there’s no doubt you want to get rid of it quickly. You may be wondering if an antibiotic like doxycycline could help.
However, healthcare providers do not use doxycycline as a top-choice treatment for UTIs because more effective treatment options are available. With doxycycline, only a limited amount of the drug enters the urine compared to other treatment options.
Doxycycline is approved for treating UTIs, but only in specific situations. To learn more about this, along with how effective doxycycline is for UTIs, its dosage, and side effects, among other information, keep reading this article.
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What Is Doxycycline?
Doxycycline is a commonly prescribed antibiotic classified within the tetracycline class of antibiotics.
It is administered in multiple formulations, most commonly via oral capsules and tablets.
However, liquid and injection forms are also available. As mentioned, doxycycline comes in generic and brand versions, such as Vibramycin, Monodox, and Doryx.
Doxycycline is FDA-approved in adults and older children to treat a wide range of bacterial infections, including acne, respiratory tract infections, and certain sexually transmitted infections (STIs), such as chlamydia.
Off-label Uses
Besides its FDA-approved uses, providers frequently prescribe doxycycline off-label for Lyme disease, among other conditions.
The drug also has anti-inflammatory effects, making it helpful in treating acne and rosacea by reducing redness and swelling.
How It Works
Doxycycline belongs to a class of antibiotics called tetracyclines. It works by blocking the growth of bacteria in the body.
Furthermore, one of the critical benefits of doxycycline is its broad-spectrum antibacterial activity, meaning it is effective against a wide range of bacteria.
Doxycycline interferes with the bacteria's ability to produce specific proteins essential for survival and replication.
Inside bacterial cells, there are structures called ribosomes that are responsible for making proteins. Doxycycline disrupts the function of these ribosomes, which prevents protein production.
This leads the bacteria to stop growing, which causes them to die.
Doxycycline also has anti-inflammatory properties, which can help to reduce swelling associated with some bacterial infections.
Note that doxycycline is not effective against viruses or fungi. Therefore, you should only take doxycycline as directed by a healthcare provider and not take it for viral infections, such as the common cold.
How Effective Is Doxycycline for a UTI?
Doxycycline isn't the most popular choice when healthcare providers recommend an antibiotic to treat a UTI.
Instead, the most common type of UTI is cystitis, which is a bladder infection. And doxycycline has relatively limited bladder penetration compared to other available antibiotics.
That being said, the FDA has approved doxycycline for treating UTIs in certain situations, including:
Urethritis caused by chlamydia or Ureaplasma urealyticum
Complicated UTI caused by Klebsiella species, if testing shows that the bacteria is sensitive to doxycycline
When Is Doxycycline Recommended for UTIs?
Even though the FDA has approved a medication for a particular purpose, it doesn’t mean it’s the best choice.
The Infectious Disease Society of America (IDSA) experts do not routinely recommend doxycycline for UTIs because more effective options are available.
They especially recommend avoiding doxycycline for UTIs in children 8 years old and younger, as the drug may result in permanent tooth discoloration.
The effectiveness of doxycycline for treating UTIs depends on the specific strain of bacteria causing the infection.
Your healthcare provider may have you provide a urine sample so they can identify the specific bacteria and determine which antibiotics will work against it.
For example, Escherichia coli (E. coli) is a common bacterial strain treated by antibiotics.
Preferred Treatment Options for UTIs
Other bacteria can also lead to UTIs; some strains may resist doxycycline and other antibiotics.
Bactrim (sulfamethoxazole/trimethoprim) is the first choice for uncomplicated UTIs.
However, if an individual is allergic to sulfa medications or unable to take them for other reasons, doxycycline may be considered as an alternative.
Dosing Guidelines for UTI Treatment
The table below summarizes the preferred antibiotic options for UTIs, according to treatment guidelines from the IDSA:
Uncomplicated cystitis (bladder infection): | Pyelonephritis (kidney infection): | |
First-line antibiotics: | • Sulfamethoxazole/trimethoprim | • Fluoroquinolone, such as Cipro (ciprofloxacin) |
Second-line antibiotics: | • Fluoroquinolones, such as Cipro (ciprofloxacin) | • Certain cephalosporins, such as ceftriaxone |
A healthcare provider will make the specific antibiotic selection based on the specific circumstances of your infection and your unique medical history.
Common Dosage: Doxycycline for UTIs
When healthcare providers prescribe doxycycline for an adult infection, the typical dosage is 100 mg taken by mouth twice daily.
For children ages 8 years and older, healthcare providers calculate the dose using the child’s body weight. It’s usually given twice a day.
Taking each dose of doxycycline with a full glass of water is important. You can take doxycycline with or without food.
How Quickly Will Doxycycline Work?
The typical treatment length of doxycycline is seven to 10 days, but this can vary with the type and severity of the infection being treated.
Doxycycline starts working immediately, but it may take one to two days to start feeling better, and it requires the entire course of treatment for complete treatment.
Skipping doses or not completing the entire course of doxycycline can result in the infection not being fully treated and the bacteria becoming resistant to the antibiotic.
This can make your symptoms come back and make the infection more difficult to treat.
Doxycycline In Combination With Other Drugs
To help relieve UTI symptoms quickly, healthcare providers may recommend taking other medications in addition to the antibiotic.
A typical example is phenazopyridine, which is available with a prescription as Pyridium and without a prescription as Azo Urinary Pain Relief or Uristat.
It works to numb the pain with urination associated with UTIs. Note that this medication discolors the urine orange.
Doxycycline may not be the right antibiotic for a UTI. If your symptoms aren’t going away, talk with your provider. They may order additional testing or recommend a different treatment.
Side Effects and Precautions
Doxycycline is a generally well-tolerated and safe medication, but like any medication, doxycycline can cause side effects in some people.
The most common side effects include nausea, vomiting, diarrhea, and abdominal pain. It can also cause skin sensitivity to sunlight, leading to sunburn or skin rash.
Like other antibiotics, taking doxycycline may lead to a vaginal yeast infection.
In rare cases, more severe side effects may occur, such as:
Severe allergic reaction, leading to hives, difficulty breathing, or trouble swallowing.
If you experience any of these symptoms while taking doxycycline, seek medical attention immediately.
There are also certain precautions to be aware of before taking doxycycline. Nursing people should not take this medication, as it can pass through breast milk to a nursing baby.
It should also be avoided or used with caution in children younger than 8 years old or pregnant women, as it can cause permanent yellowish-brown discoloration of the teeth in children or fetuses.
Taking Doxycycline Safely
Doxycycline can interact with certain foods, medications, and dietary supplements, potentially reducing effectiveness or increasing the side effects.
Medications, foods, and supplements that contain minerals can bind to doxycycline in the digestive tract, preventing it from being fully absorbed into the bloodstream.
Therefore, it is crucial to space these products at least two to four hours apart from doxycycline:
Examples include:
Antacids containing aluminum, calcium, or magnesium, such as Tums (calcium carbonate) and Maalox (aluminum/magnesium hydroxide)
Calcium, magnesium, or iron supplements, including multivitamins with minerals
Laxatives containing magnesium, such as Citroma
Pepto Bismol (bismuth subsalicylate) should be avoided while taking doxycycline.
Similarly, foods and beverages containing minerals can also interact with doxycycline. Dairy products, such as milk, yogurt, and cheese, can bind to doxycycline and reduce its effectiveness.
Avoid consuming dairy or calcium-fortified products two hours before or after your dose for best results.
Other medications can interact with doxycycline, such as:
Warfarin. This blood thinner’s effects may be increased by doxycycline, raising the risk of bleeding.
Certain seizure medications, such as phenobarbital, Tegretol (carbamazepine), and Dilantin (phenytoin). These drugs may make doxycycline less effective.
Methoxyflurane. Taking this drug with doxycycline may cause severe kidney problems.
Birth control pills. Doxycycline could make oral contraceptives less effective; consider using a backup method to prevent pregnancy.
Penicillin. Doxycycline could make penicillin less effective.
Discuss any potential drug interactions with your healthcare provider.
They can guide you on preventing or managing these interactions and adjust your medications or diet if necessary.
Summary
Doxycycline isn't usually the first choice for UTIs. Still, it could be prescribed in certain situations or as an alternative for UTIs that are difficult to treat or keep coming back.
For instance, doxycycline may be prescribed after the results of urine culture testing show that specific bacteria like Klebsiella species is causing the infection if the sensitivity testing results confirm that doxycycline is effective against that bacteria.
In cases where an individual is allergic to other antibiotics or if the UTI-causing bacteria is resistant to multiple other antibiotics, doxycycline may be a safe and effective option.
Overall, UTIs are common and treatable infections, and a healthcare provider can determine the appropriate treatment.
By seeking prompt medical attention and following the treatment plan as prescribed, most people recover from a UTI without any long-term complications.
Read the original article on Verywell Health.
