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Men With UTI Do Fine With Shorter Course of Antibiotics

In two VA Hospitals, a 7-day course of antibiotics worked as well as two weeks of pills to overcome urinary tract infection symptoms.

When women came down with urinary tract infections that cause frequency, urgency or pain on urination, the standard antibiotic course used to be 7 to 14 days. Now, doctors more often prescribe a shorter course of antibiotics, 3 to 5 days. However, this change has not been adopted for treating men.

Testing a Shorter Course of Antibiotics for Men:

Men are less prone to such infections, but if they do come down with one, current treatment generally lasts two weeks. A study from two VA Hospitals compared seven days of treatment to the standard 14 days (JAMA, July 27, 2021).

How Well Did Men Do With Just One Week of Pills?

The investigators found that the shorter course of antibiotics worked just as well, at least in men who were not running a fever. At two weeks after diagnosis, there was no significant difference in symptoms between the two groups. Moreover, they also did not differ with regard to side effects or recurrence of symptoms after treatment.

According to an accompanying editorial,

“For men with symptoms of lower UTI without fever or other evidence of systemic disease, 7 days of antibiotics should become a standard approach and shorter courses of therapy may be equally effective.”

Previously, doctors worried that shortening the course of antibiotics would fail to knock out the infection. As a result, the bacteria might have a chance to develop resistance. Current thinking favors less exposure to antibiotics overall to reduce the risk of resistance. Seven days of treatment seemed to knock the infection out,  supporting the “less is best” approach.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Drekonja D et al, "Effect of 7 vs 14 days of antibiotic therapy on resolution of symptoms among afebrile men with urinary tract infection: A randomized clinical trial." JAMA, July 27, 2021. doi:10.1001/jama.2021.9899
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