Why Antibiotics Are The Golden Standard
Urinary tract infections occur due to an external bacterial infection in the urinary tract of a body. The most common treatment option is a course of antibiotic therapy that targets the pathogens and the bacteria causing the infection.
The appropriate antibiotic course leads to higher symptomatic and bacteriological cure rates and significantly reduces the chances of reinfection. The types of antibiotics prescribed as the first line of treatment are based upon the type of bacteria found in your urine after the urine analysis, your health status, and the severity of the infection.
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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.
Does Cranberry Juice Prevent A Uti
Some patients may want to use cranberry or cranberry juice as a home remedy to treat a UTI. Cranberry juice has not been shown to cure an ongoing bacterial infection in the bladder or kidney.
Cranberry has been studied as a preventive maintenance agent for UTIs. Studies are mixed on whether cranberry can really prevent a UTI. Cranberry may work by preventing bacteria from sticking to the inside of the bladder however, it would take a large amount of cranberry juice to prevent bacterial adhesion. More recent research suggests cranberries may have no effect on preventing a UTI
- According to one expert, the active ingredient in cranberries — A-type proanthocyanidins — are effective against UTI-causing bacteria, but is only in highly concentrated cranberry capsules, not in cranberry juice.
- However, cranberry was not proven to prevent recurrent UTIs in several well-controlled studies, as seen in a 2012 meta-analysis of 24 trials published by the Cochrane group.
- While studies are not conclusive, there is no harm in drinking cranberry juice. However, if you develop symptoms, see your doctor. Some people find large quantities of cranberry juice upsetting to the stomach.
Increasing fluid intake like water, avoiding use of spermicides, and urinating after intercourse may be helpful in preventing UTIs, although limited data is available.
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Uncomplicated Cystitis In Nonpregnant Patients
Uncomplicated cystitis occurs in patients who have a normal, unobstructed genitourinary tract who have no history of recent instrumentation and whose symptoms are confined to the lower urinary tract. Uncomplicated cystitis is most common in young, sexually active women. Patients usually present with dysuria, urinary frequency, urinary urgency, and/or suprapubic pain. Treatment regimens for uncomplicated cystitis in nonpregnant women are provided in Table 1, below.
Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar. 52:e103-20. . .
Wagenlehner FM, Schmiemann G, Hoyme U, FÃ¼nfstÃ¼ck R, Hummers-Pradier E, Kaase M, et al. . Urologe A. 2011 Feb. 50:153-69. . .
Abrahamian FM, Moran GJ, Talan DA. Urinary tract infections in the emergency department. Infect Dis Clin North Am. 2008 Mar. 22:73-87, vi. .
Little P, Turner S, Rumsby K, Warner G, Moore M, Lowes JA, et al. Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study. Health Technol Assess. 2009 Mar. 13:iii-iv, ix-xi, 1-73. .
Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010 Dec. 7:653-60. .
Can A Uti Go Away On Its Own
While most patients with a UTI will be prescribed antibiotics, the truth is, uncomplicated urinary tract infections are often self-limiting, meaning they can potentially run their course sans antibiotic treatment, noted a 2018 report in PLoS Medicine.
In fact, that same report found that more than one-half of the women studied experienced a UTI resolution without the use antibiotics. However, since kidney infections occurred in 7 out of 181 women using ibuprofen, the researchers concluded that, at this time, they cannot recommend ibuprofen alone as initial treatment to women with uncomplicated UTIs.
A better idea, for now: Simply wait until a positive urine culture comes back before treating with antibiotics.
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Who Gets Urinary Tract Infections
Anyone can. But they’re more likely when you:
- Have had UTIs before
- Have a condition that affects your bladder’s nerves
- Have been through menopause
- Have something that blocks the passage of urine, such as a tumor, kidney stone, or an enlarged prostate
- Use a diaphragm or spermicide for birth control
- Have a catheter, a tube placed into the bladder to drain urine from the bladder into a bag outside the body
- Are a man who has sex with men, has HIV, or hasnât been circumcised
Most of these traits also raise the odds that a simple bladder infection may become a more serious kidney infection or turn into . For pregnant women, a kidney infection can lead to delivering a baby too early.
What If I Don’t Go To The Doctor
What happens when UTIs are left untreated? Contrary to popular belief, your immune system is often able to clear a UTI on its own. Studies have found that 25-42% of women are able to recover from an uncomplicated UTI without antibiotics.
But that means a majority of UTIs do not go away on their own. If left untreated, they can lead to continued discomfort and other more serious health issues, such as kidney damage or a severe infection. Therefore, treatment is recommended.
“Physicians tailor care plans to each patient, and there is no sole treatment for everyone,” says Stanford physician Kim Chiang, MD. During your visit, feel free to ask in-depth questions, particularly if a non-recommended antibiotic is prescribed.
This is the fifth post in the series Understanding UTIs. The goal of this seven-part series is to provide easy-to-understand, scientifically grounded information about UTIs. Patients referenced are composites, compiled from actual patient experiences.Data on medications used for UTIs were extracted from the National Disease and Therapeutic Index, a nationally representative physician survey produced by IQVIA.
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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 Bladder Urinary Tract Infections
The specific intervention depends on the severity of the symptoms. In many instances, healthy patients who have a urinary tract infection but have no symptoms require no treatment at all. Such asymptomatic UTIs typically resolve within two to three days.
If urinary tract infection symptoms are presentsuch as a burning sensation during urination or an increased need to urinatetreatment usually consists of antibiotic medications, which are prescribed for three to 14 days. They include:
- Trimethoprim: Trimethoprim is the standard treatment for urinary tract infections in otherwise-healthy adults. It is one of the more potent UTI antibiotics, so most patients only require a three-day course. Trimethoprim is generally well-tolerated with few side effects, which generally include nausea, vomiting, diarrhea/constipation or stomach pain.
- Nitrofurantoin: Nitrofurantoin is the second most commonly prescribed antibiotic for bladder UTIs. It usually requires a longer course than trimethroprim , and is usually well tolerated but should not be taken by anyone with kidney disease. Side effects include nausea and vomiting.
- Cephalosporins: Cephalosporins are often used as a first-line of treatment in patients that have upper urinary tract infections involving the ureters or kidneys. It is usually taken for seven to 10 days. Side effects include nausea, vomiting, upset stomach and diarrhea.
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The Status Of Phenazopyridine
In 1983, the FDA published a Drug Efficacy StudyImplementation notice with conditions for approval and marketingof all phenazopyridine products.7 These includedsulfameth-oxazole/phenazopyridine combinations ,similar combination products, and single-entity phenazopyridineproducts. The FDA presented newlyrequired statements for all phenazopyridine products intended to relievesymptoms associated with a UTI. One of the statements was critical indetermining the length of dosing: Treatment of a urinary tractinfection with phenazopyridine HCl or a combination drug productcontaining phenazopyridine HCl should not exceed 2 days because there isa lack of evidence that the combined administration of phenazopyridineHCl and an antibacterial provides greater benefit than administration ofthe anti-bacterial alone after 2 days.7
The FDA also required the following carcinogenicitystatement on all phenazopyridine labels: Long-term administration ofphenazopyridine hydrochloride has induced neoplasia in rats and mice . Although no association betweenphenazopyridine hydrochloride and human neoplasia has been reported,adequate epidemiological studies along these lines have not beenconducted.7
The best known phenazopyridine nonprescription product is Azo Standard.9Azo Standard contains 95 mg of phenazopyridine per tablet and AzoStandard Maximum Strength contains 97.5 mg of phenazopyridine.10 The dosage of both is 2 tablets 3 times daily with or after meals as needed.
Can A Person Get Rid Of A Uti Without Antibiotics
In some cases, the body can resolve mild, uncomplicated UTIs without antibiotics. Research suggests that 2542% of uncomplicated UTIs resolve without medical treatment.
However, not receiving treatment for a UTI does have some risks. As such, older adults, pregnant people, and those with underlying conditions should not try to treat their UTIs without antibiotics.
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How Long To Take Antibiotics For A Uti
Very severe or complicated UTI cases may need up to 14 days of medication, but most patients with uncomplicated UTIs only require 3-7 days of treatment to fully eradicate their infection.
The exact number of doses needed depends on which antibiotic you are taking.
You should always make sure to take the full course of antibiotics that your healthcare provider prescribes to you to avoid antibiotic resistance in the future, even if symptoms improve before youre done.
What Are Uti Symptoms
Symptoms of UTIs may include the following: pain or burning when urinating, pressure in the low belly, an urge to urinate often, and fatigue and shakiness. If you have severe pain in your back or lower abdomen, vomiting, nausea, or fever, see your healthcare provider immediately. These can be signs of a serious kidney infection. Speak with your healthcare provider if you think you may have a UTI.
- Urinary Tract Infection, Centers for Disease Control and Prevention . Web. 20 September 2021.
- Bladder Infection in Adults, National Institute of Health . Web. 20 September 2021.
- Urinary Tract Infections, MedlinePlus. Web. 20 September 2021.
- Urinary Tract Infections, Mayo Clinic. Web. 20 September 2021.
- Phenazopyridine, MedlinePlus. Web. 21 September 2021.
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What Causes A Uti
Urinary tract infections occur when bacteria enters through the urethra. The bacteria may take hold in theurethra or go into the bladder. If left unchecked, this bacteria could multiply and grow into a full-blowninfection. Women are more likely to develop urinary tract infections than men because they have shorterurethras.
What You Need To Know About Resistant Urinary Tract Infections
U.T.I.s are one of the worlds most common infections, but many of the drugs used to treat them have become less effective as resistance to antibiotics grows.
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By Matt Richtel
Urinary tract infections, or U.T.I.s, are one of the worlds most common infections. Increasingly, they also are resistant to major drug treatments. Heres what you should know.
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Are Utis Serious
Most UTIs are not serious if they are treated rapidly andappropriately. But some can lead to dangerous problems, such as kidneyinfections. You may lessen the risk of this by promptly seeing aphysician, getting your antibiotic/antimicrobial prescription filled,and taking the medication exactly as directed to kill the organisms. Ifyou fail to do so, a kidney infection can occur and become chronic.Chronic kidney infections can lead to permanent damage, such as scarringof the kidneys, reduced kidney function, hypertension, and otherissues.
What Is A Uti
A UTI is caused by bacteria entering the urethra and infecting the urinary tract. A UTI can affect different parts of the urinary system such as the kidneys, urethra, bladder, or ureters. Over 150 million people experience UTIs globally and the United States sees over 3 million cases every year.
The bacteria Escherichia coli is well known for being the most common cause of UTIs. This bacteria lives in the gut but can easily make its way into the urinary tract system. Examples of how this might happen include wiping back to front after urination, wearing pants that are too tight, or by not urinating after sexual intercourse. UTIs can also be caused by viruses, fungi, certain medical conditions, or abnormalities of the urinary tract.
Once bacteria have infected a part of the urinary system, symptoms could manifest as a burning sensation during urination, pelvic pain, nausea and vomiting, fever and chills, or bloody urine. Most urinary tract infections are treated with antibiotics, though some people rely on natural and home remedies to relieve their symptoms.
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Seek Medical Attention For Utis
It is important to seek medical attention if you think you may have a UTI particularly if you think you may have a bladder or kidney infection, both of which are very serious conditions. Early treatment of urinary infection can help to prevent infection spreading to the bladder or kidneys.
Your doctor will test your urine to check which micro-organism is present. Urinary tract infections usually respond quickly and well to antibiotics.
How Is A Uti Diagnosed
Urinary tract infections are very commonly self-diagnosed , though sometimes a urinalysis is necessary. Collecting a urine sample or urine culture could help doctors determine what type of bacteria is in the urine. After that, an appropriate antibiotic can be prescribed.
People who experience recurring UTIs may recognize the characteristic symptoms of a UTI: pain while urinating, blood in the urine, a frequent need to urinate, flu-like symptoms, and pain or pressure in the lower abdomen.
According to the Centers for Disease Control and Prevention , women experience more UTIs than men do. This is because women have a shorter urethra than men and because their urethra is closer to the rectum. These factors increase the likelihood of bacteria reaching the urinary system. People with weakened immune systems such as the elderly are at a higher risk of getting UTIs. Children are prone to becoming infected as well, especially while potty training.
UTIs can fall into one of two categories: lower or upper tract infections. Lower tract infections include urethritis and cystitis . If lower tract infections are left untreated, this can lead to an upper tract infection where bacteria reach the ureters and kidneys. Kidney infections can be very painful and are especially dangerous for pregnant women.
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What Antibiotics Are Commonly Used To Treat Urinary Tract Infections
A handful of antibiotics are used to treat the most common urinary tract infections . In 75-95% of these cases, the infection is caused by bacteria called Escherichia coli , so experts know which antibiotics work well against the infection. These antibiotics are called first-line antibiotics.
They are given orally and include:
Amoxicillin and ampicillin are no longer used because of a high level of antibiotic resistance.
Do I Really Need To Take Antibiotics For A Uti
In most cases, it makes sense to start antibiotics if you know you have a bacterial UTI since this is the only way to treat it.
While it is possible for a UTI to go away on its own, this doesnt always happen. Plus, youll still have to deal with uncomfortable UTI symptoms like pain during urination while waiting to see if the UTI will go away. And if it doesnt, the infection can travel up your urinary tract and cause a more serious infection in your kidneys called pyelonephritis. If youre pregnant, have underlying health conditions, or are older than 65 years old, you should not try to treat a UTI without antibiotics.
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Recurrent Urinary Tract Infections
Patients with three or more infections per year should be offered either continuous low-dose antibiotic prophylaxis, patient-initiated, or postcoital prophylaxis if the onset of infection is linked to sexual intercourse .7 Before a prophylactic regimen is chosen, a urine culture should be performed to determine the susceptibility of the pathogen. The duration of continuous prophylactic therapy is usually 6 months to a year. Unfortunately, within 6 months of discontinuing antibiotic prophylaxis, 40% to 60% of women develop a urinary tract infection, and prophylaxis must be resumed.20 Patient-initiated therapy at the onset of symptoms has been shown to be effective in young, healthy nonpregnant women.21 Short-course regimens have been advocated for patient-initiated therapy in compliant women with frequently recurring and symptomatic urinary tract infections. The major advantages of short-course therapy over continuous therapy are convenience and the avoidance of antibiotic toxicity symptomatic infections are not prevented, however. For postcoital prophylaxis, nitrofurantoin, trimethoprim-sulfamethoxazole, or fluoroquinolones taken within 2 hours after sexual intercourse have been shown to significantly reduce the incidence of recurrent cystitis.22, 23