Welcome to our UTI Knowledge Center! Here you will find links to individual posts for each antibiotic tested in the Guidance® UTI assay. These spotlights aim to answer common questions about each antibiotic. Each spotlight post has several sections describing key features of the antibiotic. Continue reading below to learn about each section.
Administration Routes
This section lists the available administration route(s) for the listed antibiotic. This information comes from the FDA-approved product labels and package inserts.[1] Some antibiotics for UTI can be taken orally (PO).[2] Others need parenteral administration. Parenteral administration routes include[2]:
- Intravenous infusion (IV)
- Intramuscular injection (IM)
PO is the least invasive administration route and is usually the preferred option in outpatient care. The IM route may be utilized in clinical offices. IV is the most invasive option, usually given at a specialized facility.
Bacteriostatic or Bactericidal
“Bactericidal” antibiotics directly kill bacteria. “Bacteriostatic” antibiotics prevent bacterial growth and replication. Both types of antibiotics are effective in clinical practice.[3]
Antibiotic Class
This section lists the class of the antibiotic. Antibiotic classes describe groups of antibiotics with related:[4]
- Molecular structures
- Mechanism(s) of action
Mechanisms of Action
This section provides a brief description of how the antibiotic works. The “mechanism of action” blocks one of four bacterial processes: [5]
- Bacterial Cell Wall Building
- Bacteria DNA Replication and Repair
- Bacterial Ribosomes and Protein Synthesis
- Bacterial Folate Metabolism
WHO AWaRe Classification
The World Health Organization (WHO) has developed the AWaRe classification system.[4] The goal is to support global antibiotic stewardship efforts. AWaRe stands for “Access”, “Watch”, and “Reserve”. These three classes describe the appropriate stewardship for the antibiotic:
- Access: These antibiotics are lower-risk for antibiotic resistance. They should be considered for first-line and empiric uses.
- Watch: These antibiotics are higher-risk for antibiotic resistance. They should be used for infections with confirmed susceptibility.
- Reserve: These antibiotics are for infections with multi-drug-resistant organisms. They are considered ‘last resort’ options.
Empiric Use Recommendations
Antibiotics recommended for empiric therapy are marked “yes”. Recommendations come from guidelines by the following organizations:
- World Health Organization (WHO)[4]
- Infectious Diseases Society of America (IDSA) & European Society for Microbiology and Infectious Disease[6]
- American Urological Association (AUA)[7]
Indication(s) Relevant to UTI
This section lists any UTI-related indications for use. Indications are according to FDA-approved product labels and package inserts.[1]
Checkmarks
This section lists which organisms from the Guidance® UTI test can be treated by the antibiotic. These recommendations appear as checkmarks on Guidance® UTI result reports.
Sources are 1) the Clinical and Laboratory Standards Institute (CLSI),[8] 2) the United States Food and Drug Administration (FDA)[9]:
- M100: Performance Standards for Antimicrobial Susceptibility Testing, 35th Edition (2025)
- M43-A: Methods for Antimicrobial Susceptibility Testing for Human Mycoplasmas, 1st Edition (corrected 2015)
- M45: Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria, 3rd Edition (corrected 2017)
The CLSI and FDA guidance documents do not provide guidance for treatment of A. schaalii, A. omnicolens, or G. vaginalis. Instead, primary peer-reviewed literature references are provided where applicable. [10–18]