Check If It’s A Urinary Tract Infection
Symptoms of a urinary tract infection may include:
- pain or a burning sensation when peeing
- needing to pee more often than usual during the night
- pee that looks cloudy, dark or has a strong smell
- needing to pee suddenly or more urgently than usual
- needing to pee more often than usual
- lower tummy pain or pain in your back, just under the ribs
- a high temperature, or feeling hot and shivery
- a very low temperature below 36C
Treatment Of Recurrent Utis
Some people develop recurring urinary tract infections and may require further testing to determine the cause. Treatment may include longer doses of antibiotics or more potent doses of antibiotics delivered intravenously. Recurrent UTIs may be a symptom of a more chronic problem and require further examination by a trained urologist.
References
Couling, R. . Managing lower UTI in adults in the community. Nurse Prescribing. 6, 485-489.
Huang, C.-H. et al. . Cranberry-Containing Products for Prevention of Urinary Tract Infections in Susceptible PopulationsA Systematic Review and Meta-analysis of Randomized Controlled Trials. Archives of Internal Medicine. 172:988-996.
OShea, L. . Diagnosing urinary tract infections. Practice Nurse. 40, 20-25.
Riley, J. . Urinary tract infection. Conditions and Procedures in Brief, 1-3.
Stapleton, A.E. et al. . Recurrent Urinary Tract Infection and Urinary Escherichia coli in Women Ingesting Cranberry Juice Daily: A Randomized Controlled Trial. Mayo Clinic Proceedings. 87:143-150.
Urinary tract infection. . Mayo Clinic. Retrieved from .
Urinary tract infectionCauses. . University of Maryland Medical Center.
Urinary tract infections in adults. . National Kidney and Urologic Diseases Information. Publication No. 122097.
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Am I At Risk Of A Uti
While UTIs can happen to anyone, they are more common in females who are sexually active or menopausal, or have health conditions such as diabetes or urinary incontinence. Females who use spermicides or diaphragms as contraception are also at increased risk of UTIs, and may benefit from other contraceptive options if they get recurrent UTIs.
Some people at greater risk of developing urinary tract infections:
- Females nearly 1 in 3 females will have a UTI that needs treatment before the age of 24.
- Males with prostate problems an enlarged prostate gland can cause the bladder to only partially empty, raising the risk of infection.
- Older people some medications and problems with incontinence mean that older people are more likely to get a UTI.
- People with urinary catheters people who are critically ill and people who cant empty their bladder are at a greater risk of infection.
- People with diabetes changes to the immune system make people with diabetes more vulnerable to infection.
- Infants babies in nappies commonly get UTIs, in particular, infants born with physical problems of the urinary system are at greater risk.
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What Can Happen If A Uti Is Not Treated
If treated right away, a UTI is not likely to damage your urinary tract. But if your UTI is not treated, the infection can spread to the kidneys and other parts of your body. The most common symptoms of kidney infection are fever and pain in the back where the kidneys are located. Antibiotics can also treat kidney infections.
Sometimes the infection can get in the bloodstream. This is rare but life-threatening.
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When Should I Seek Medical Treatment For Luts
Its important to talk to a healthcare provider if you have any lower urinary tract symptoms. Even if the symptoms are mild, they may be signs of a developing health problem. And treatment can be more effective if started early.
Its especially important to seek medical attention if LUTS are:
- Accompanied by blood in your pee.
- Causing discomfort or pain.
- Leading to anxiety or depression.
- Affecting your relationships, such as making you avoid social situations, intimacy or sex.
- Preventing you from doing the things you enjoy or leaving your house.
A note from Cleveland Clinic
Lower urinary tract symptoms include a wide variety of problems with urination. Examples include involuntarily leaking urine or having sudden and strong urges to pee. LUTS may be signs of a health problem, so its important to talk to a healthcare provider.
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Treatment From A Gp For Utis That Keep Coming Back
If your UTI comes back after treatment, or you have 2 UTIs in 6 months, a GP may:
- prescribe a different antibiotic or prescribe a low-dose antibiotic to take for up to 6 months
- prescribe a vaginal cream containing oestrogen, if you have gone through the menopause
- refer you to a specialist for further tests and treatments
In some people, antibiotics do not work or urine tests do not pick up an infection, even though you have UTI symptoms.
This may mean you have a long-term UTI that is not picked up by current urine tests. Ask the GP for a referral to a specialist for further tests and treatments.
Long-term UTIs are linked to an increased risk of bladder cancer in people aged 60 and over.
Pain Relief Vs Antibiotics
New Zealand guidelines do not currently support the use of NSAIDs in favour of antibiotics. The results of two recent large randomised trials found that antibiotics reduce symptom duration on average by around 2 days, and reduce the risk of pyelonephritis. On the beneficial side, around half to two thirds of women who use NSAIDs do not end up needing antibiotics. Shared decision making should used in conjunction with your patient. Kronenberg A, Bütikofer L, Odutayo A, et al. Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial. BMJ 2017 359:j4784.
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Recommendations For Uti Prevention
To prevent urinary tract infection, some research suggests that the following may be helpful:
- Increasing fluid intake: The doctor may recommend increased fluid intake to help flush bacteria out of the urinary system.
- Drinking cranberry juice: Drinking 8 ounces of cranberry juice a day may help prevent recurrent UTIs. People who take blood thinners such as warfarin or are prone to kidney stones should check with a physician before trying this approach.
- Proper hygiene: Regular bathing keeps the genital area bacteria free, and women should wipe front-to-back after using the bathroom so as to avoid introducing bacteria into the urethra.
How Relevant Is This To My Practice
Uncomplicated lower UTI remains one of the most commonly treated infections in primary care. The urinary tract is a common source of infection in children and infants and is the most common bacterial infection in children < 2 years of age, both in the community and hospital setting. During the first six months of life, UTIs are more common in boys. The outcome is usually benign, but UTIs can progress to renal scarring in early infancy, especially when associated with congenital anomalies of the urinary tract. Renal scarring may lead to complications in adulthood including hypertension, proteinuria, renal damage and even chronic renal failure, which requires dialysis treatment.
In general, 40% of women develop a UTI at some point in their life. In Singapore, 4% of young adult women are affected and the incidence increases to 7% at 50 years of age. Adult women are 30 times more likely than men to develop a UTI, with almost half of them experiencing at least one episode of UTI during their lifetime. It is reported that one in three women have their first episode of UTI by the age of 24 years. UTIs are most commonly seen in sexually active young women. Other susceptible adults include the elderly and patients requiring urethral catheterisation.
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Condom Use During Sex
Non-lubricated latex condoms may increase friction and irritate the skin during sexual intercourse. This may increase the risk of a UTI.
But there are many reasons to use condoms. Theyre important for reducing the spread of sexually transmitted infections and preventing unwanted pregnancy.
To help prevent friction and skin irritation from condoms, be sure to use enough water-based lubricant during sex.
Avoid using condoms coated with spermicide.
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How Is A Chronic Urinary Tract Infection Diagnosed
If you have a chronic UTI, you probably had a UTI in the past.
Performing lab tests on a sample of urine is the most common method doctors use to diagnose UTIs. A medical professional will examine the sample of urine under a microscope, looking for signs of bacteria.
In a urine culture test, a technician places a urine sample in a tube to encourage the growth of bacteria. After one to three days, theyll look at the bacteria to determine the best treatment.
If your doctor suspects kidney damage, they may order X-rays and kidney scans. These imaging devices take pictures of parts inside your body.
If you have recurring UTIs, your doctor may want to perform a cystoscopy. In this procedure, theyll use a cystoscope. Its a long, thin tube with a lens at the end used to look inside your urethra and bladder. Your doctor will look for any abnormalities or issues that could cause the UTI to keep coming back.
How Common Are Urinary Tract Infections
Urinary tract infections are very common, occurring in 1 out of 5 women sometime in their lifetime. Though UTIs are common in women, they can also happen to men, older adults and children. One to 2% of children develop urinary tract infections. Each year, 8 million to 10 million visits to doctors are for urinary tract infections.
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Other Ways To Prevent Some Utis Coming Back
If you keep getting a bladder infection , there’s some evidence it may be helpful to take:
- D-mannose a sugar you can buy as a powder or tablets to take every day
- cranberry products available as juice, tablets or capsules to take every day
Speak to your doctor before taking any of these during pregnancy.
Be aware that D-mannose and cranberry products can contain a lot of sugar.
If you’re taking warfarin, you should avoid cranberry products.
Page last reviewed: 22 March 2022 Next review due: 22 March 2025
Whats The Difference Between A Urinary Tract Infection And Bladder Infection
A urinary tract infection is a more general type of infection. There are many parts of your urinary tract. A UTI is a term for an infection that takes place throughout the urinary tract. A bladder infection, also called cystitis, is a specific infection. In this infection, bacteria makes its way into the bladder and causes inflammation.
Not all urinary tract infections become bladder infections. Preventing the spread of the infection is one of the most important reasons to treat a UTI quickly when you have symptoms. The infection can spread not only to the bladder, but also into your kidneys, which is a more complicated type of infection than a UTI.
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Patients With A Catheter
The urinary tract is the most common source of nosocomial infection, especially in patients with catheters.10 In these patients, bacteriuria is expected within a few days due to colonisation, although in the short term it is usually asymptomatic and from a single organism. Catheterisation for longer than 30 days is associated with colonisation with multiple organisms.
Catheterised patients with bacteriuria should only be treated if they are symptomatic or about to undergo a urological procedure. Such signs or symptoms may include fever, rigors, altered mental status, malaise, lethargy with no other identified cause, flank pain, acute haematuria, or pelvic discomfort. Pyuria alone is not diagnostic of catheter-associated infection.11 The catheter should be changed at the time of antibiotic treatment.
Urinary Tract Infection : Antimicrobial Prescribing
NICE guideline
This guideline sets out an antimicrobial prescribing strategy for lower urinary tract infection in children, young people and adults who do not have a catheter. It aims to optimise antibiotic use and reduce antibiotic resistance.
See a 3-page visual summary of the recommendations, including a table to support prescribing decisions.
- People with lower urinary tract infection, their families and carers
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Enhancing Healthcare Team Outcomes
UTIs are best managed in an interprofessional fashion, and besides physicians, most nurses will encounter a patient with a UTI. The key to preventing recurrences is patient education. Once a UTI has been diagnosed, the patient should be encouraged to drink more fluids. Sexually active women should try to void right after sexual intercourse as this can help flush the bacteria out of the bladder. Some women with recurrent UTIs may benefit from the prophylactic use of antibiotics. Several other non-medical remedies may help some women with UTIs. Anecdotal reports indicate that using cranberry juice and probiotics may help reduce the severity and frequency of UTIs in some women. Primary clinicians should refer patients with recurrent UTIs to the urologist to rule out reflux and anatomical defects.
Outcomes
The majority of women with a UTI have an excellent outcome. Following treatment with an antibiotic, the duration of symptoms is 2 to 4 days. Unfortunately, nearly 30% of women will have a recurrence of the infection. Morbidity is usually seen in older debilitated patients or those with renal calculi. Other factors linked to recurrence include the presence of diabetes, underlying malignancy, chemotherapy, and chronic catheterization of the bladder. The mortality after a UTI is close to zero.
A Pharmacist Can Help With Utis
You can ask a pharmacist about treatments for a UTI.
A pharmacist can:
- offer advice on things that can help you get better
- suggest the best painkiller to take
- tell you if you need to see a GP about your symptoms
Some pharmacies offer a UTI management service. They may be able to give antibiotics if they’re needed.
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Should Uti Treatment Vary According To Whats Causing The Infection
Your UTI treatment may vary according to whats causing the infection. Certain UTIs, especially chronic and recurring ones, will need antibiotic treatment as opposed to simple home remedies.
If youre prescribed antibiotics to treat a UTI, a healthcare professional may choose an antibiotic thats specific to the type of bacteria thats triggering your infection.
Managing Lower Urinary Tract Infection
1.1.1 Be aware that lower urinary tract infection is an infection of the bladder usually caused by bacteria from the gastrointestinal tract entering the urethra and travelling up to the bladder.
1.1.2 Give advice about managing symptoms with self-care to all people with lower UTI.
Treatment for women with lower UTI who are not pregnant
1.1.3 Consider a back-up antibiotic prescription or an immediate antibiotic prescription for women with lower UTI who are not pregnant. Take account of:
-
the severity of symptoms
-
the risk of developing complications, which is higher in people with known or suspected structural or functional abnormality of the genitourinary tract or immunosuppression
-
the evidence for back-up antibiotic prescriptions, which was only in non-pregnant women with lower UTI where immediate antibiotic treatment was not considered necessary
-
previous urine culture and susceptibility results
-
previous antibiotic use, which may have led to resistant bacteria
-
preferences of the woman for antibiotic use.
1.1.4 If a urine sample has been sent for culture and susceptibility testing and an antibiotic prescription has been given:
-
review the choice of antibiotic when microbiological results are available, and
-
change the antibiotic according to susceptibility results if bacteria are resistant and symptoms are not already improving, using a narrow-spectrum antibiotic wherever possible.
Treatment for pregnant women and men with lower UTI
1.1.7 For pregnant women with lower UTI:
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This Article Has A Correction Please See:
- Accepted 9 October 2017