Urinary Tract Infections: New Antibiotic Coming Soon - Healthline

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Experts say antibiotics can be effective in treating infections, but they should be used only when necesssary. The Good Brigade/Getty Images

• Officials are reporting that the antibiotic gepotidacin is performing so well in trials that it might be available sooner than expected to help treat urinary tract infections.
• If approved, gepotidacin would be the first new antibiotic to treat urinary tract infections in more than 20 years.
• Experts say a new treatment is needed because bacteria is becoming more resistant to current antibiotics.

A new type of antibiotic for treating urinary tract infections (UTIs) may be available sooner than expected.

Gepotidacin, manufactured by the pharmaceutical company GSK, is being described as "novel" or "first-in-class" because of how it works to prevent or slow bacterial DNA replication.

If approved, gepotidacin would be the first new antibiotic developed for treating UTIs in more than 20 years. It would also be available at least a year ahead of the estimated study completion date.

Early testing has been successful enough that the Independent Data Monitoring Committee has suggested moving to the next phase. The next steps require publishing data in a medical journal and submitting data to the Food and Drug Administration (FDA) for review.

Dr. Courtenay Moore, a urologist at The Ohio State University Wexner Medical Center, told Healthline this is uncommon in pharmaceutical trials.

Dr. Cindy M. Liu, MPH, an associate professor and chief medical officer of the Antibiotic Resistance Action Center at the Department of Environmental and Occupational Health at George Washington Milken Institute School of Public Health, added that these FDA decisions are based on what other treatments are available and the risk/benefit ratio of using gepotidacin.

The clinical professional societies will also decide whether they will update their practice guidelines to include this new antibiotic, Liu told Healthline.

Julie Swann, PhD, the department head and a professor in the Fitts Department of Industrial and Systems Engineering at North Carolina State University, says it's "exciting that there may be a new treatment for UTIs because we need more 'drugs' to match with the specific 'bugs' that we have, including for uncomplicated UTIs and for more complicated cases."

Liu adds there currently are limited options to treat the most common UTIs (bladder infections) because resistance to one of the antibiotics (Bactrim) has been steadily increasing.

Moore points to a 2021 report from the World Health Organization that cautioned there are not enough new antibiotics in development to overcome the increasing risk of antibiotic resistance.

"Early and effective treatments are important because otherwise, it can develop into more severe kidney and blood infections that can be life-threatening," explained Liu.

That said, Liu emphasizes that the new antibiotic still requires consumers to be cautious about when and when not to use antibiotics.

"Antibiotics can come with side effects like allergic reactions, increasing the risk for future antibiotic-resistant infections, and can cause major disruptions in our microbiome," says Liu.

"Therefore, as smart consumers we should not demand antibiotics if there is no bacterial infection and also it is always a good idea, if you are given a prescription, to ask whether it is really needed," she adds.

Liu says the best way to treat UTIs is to have a urine analysis.

You can do a urine test strip at home or submit a urine culture at a walk-in clinic if you can't get an appointment with your healthcare provider.

Dr. Swann says it's best to consult with a medical expert who can account for one's personal history and circumstances and obtain a bacterial culture if needed.

Liu adds that a urine analysis is particularly important for people who:

• have recently had a UTI
• have a fever
• are pregnant
• are immunocompromised

"If you don't have any of these other concerns and you are treating at home, then you can take pain medication and also make sure that you are drinking plenty of water to see if symptoms improve," she says.

Nonantibiotic options for reducing symptoms associated with UTIs can include increasing water intake, suggests Moore.

In people who are post-menopausal, a life stage associated with a greater risk of UTIs, Moore says to try:

• topical estrogen to normalize vaginal pH and vaginal colonization with healthy bacteria
• treatment of bowel issues (diarrhea or constipation) as they increase the risk of bacteria spread
• supplements (cranberry and D-mannose), which prevent bacterial adherence to the bladder lining

Finally, when it comes to treating UTIs at home, bear in mind that cranberry supplements and cranberry juice are different.

"Unfortunately, there is no scientific support for home remedies (like drinking cranberry juice) for treating UTIs," says Swann.

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