A new antibiotic for UTIs: how quickly does gepotidacin work?

Reviewed and approved by Mr Daniel Swallow, Consultant Urologist (GMC 6128674). Published 15 October 2026.

What the headlines say

“UTI drug improves symptoms within a day” was one headline about a new study of gepotidacin, a recently approved antibiotic for urine infections. The study was published in JAMA Network Open on 29 September 2026 and was reported by Medscape and by CIDRAP, a news service on infectious diseases.

What the study actually found

The study included 97 girls and women aged 12 or over, at 21 sites in the United States, who had symptoms of an uncomplicated urine infection (cystitis) and urine test signs of infection. Everyone took gepotidacin for five days. There was no comparison group, and symptoms were scored every day by phone.

Among the 90 women whose results could be assessed, 54% (49 of 90) said their symptoms had improved after 24 hours. That rose to about 80% at 48 hours and 90% at 72 hours. Only 3 in 100 were completely free of symptoms at 24 hours, but by day 10 symptoms had gone completely in 90% (81 of 90). Side effects were reported by 28% of the women (27 of 97). Most were mild or moderate, and the commonest were bowel problems, mainly diarrhoea. Three women stopped the medicine because of side effects, and there were no serious side effects.

Things to bear in mind: because there was no comparison group, the study cannot show whether gepotidacin works faster than other antibiotics. It was small, it was done in the United States, and few of the women were aged 65 or over. It was paid for by GSK, the company that makes the drug, and several of the authors work for GSK and own shares in it.

The medicine was approved in the UK by the MHRA in August 2025 for uncomplicated urine infections in girls and women aged 12 and over who weigh at least 40kg. The MHRA called it the first new type of oral antibiotic for these infections in nearly three decades. In the earlier trials behind that approval it worked at least as well as nitrofurantoin, a standard first-choice antibiotic. We have not found NHS guidance on when it should be used, so it may not be available through your GP.

What it means for you

This study does not show that gepotidacin is better than other antibiotics, and it is not a reason to ask for it. Which antibiotic is right for you depends on your symptoms, whether a urine test is needed, any past infections, and local resistance patterns, and that is a decision for your pharmacist or doctor. The NHS advises finishing any antibiotics you are given, even if you feel better, and says treatment can also be a painkiller, or waiting 48 hours to see whether a mild infection clears by itself.

When to see a doctor

The NHS says women and girls aged 16 to 64 who are not pregnant can see a pharmacist about the usual symptoms of a UTI: pain or burning when passing urine, needing to go more often or urgently, and cloudy urine. Ask for an urgent GP appointment or call NHS 111 if you are a man, aged 65 or over, or a child, if you have a high temperature or are shivering, have diabetes, a weak immune system or a urinary catheter, have blood in your urine or pain in your lower tummy or back, have had two infections in six months or three in a year, or if your symptoms get worse quickly or have not improved 48 hours after starting treatment. Call 999 or go to A&E if you are confused, drowsy or have difficulty speaking.

Mr Swallow’s view

This is the first new antibiotic for urine infection in years. It is only currently suitable for females.