When To See A Medical Provider
If you think you are experiencing symptoms of a UTI, dont wait to see a doctor.Most likely youll need an antibiotic prescription to treat the infection.
Your doctor might ask you to provide a urine culture to help determine whether you are suffering from a UTI. If so, they can prescribe antibiotics to help you feel better in just a few days. Urine cultures can help doctors know which bacteria is in your urine
If you are suffering from recurrent urinary tract infections, consider contacting a urologist to assess your urinary tract.
Creating Stronger Strains Of Bacteria
Over time, some species of bacteria have become resistant to traditional antibiotics. According to some research , several species of E. coli, the primary cause of UTIs, are showing increasing drug resistance.
The more a person uses an antibiotic, the greater the risk of the bacteria developing resistance. This is even more likely when a person does not take the full prescribed course of treatment.
It is essential to continue taking antibiotics until the end date that the doctor provides. Also, never share antibiotics with others.
How Do I Know If My Particular Strain Of Uti Is Resistant To A Particular Drug
The only way is to get a urine culture. The lab results will identify the germ and what would be effective in treating the infection. But it can take several days to get the results.
Most patients want an immediate prescription so doctors usually make a best-guess determination of what drug will work given a patients symptoms and history.
The importance of history cannot be overstated if you have had a previous U.T.I., a previous resistant U.T.I., or have traveled outside the country, your history can help a doctor decide which drug to use.
Increasingly, experts tell us that you should ask for a culture when you go in for a U.T.I. treatment, even if you get an immediate prescription. The culture will allow a doctor to change the drug if the first one does not work.
That said, there is an important catch about when to do a urine culture. Often, it will show bacteria in the bladder even when an infection is not present. Some amount of bacteria is normal. The Infection Disease Society of America cautions doctors against doing cultures when symptoms of a U.T.I. are not present. The culture likely presence of bacteria can then lead to prescription of unnecessary antibiotics, contributing to the rise of resistance through overuse of the drugs.
Finally, some U.T.I.s, even when there are symptoms, can clear up on their own. This is one of many reasons to seek the care of an informed professional.
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Treatment Strategies For Recurrent Utis
Recurrent urinary tract infections, defined as three or more UTIs within 12 months, or two or more occurrences within six months, is very common among women these but arent treated exactly the same as standalone UTIs. One of the reasons: Continued intermittent courses of antibiotics are associated with allergic reactions, organ toxicities, future infection with resistant organisms, and more.
Because of this, its strongly recommended that you receive both a urinalysis and urine culture from your healthcare provider prior to initiating treatment. Once the results are in, the American Urological Association suggests that healthcare professionals do the following:
- Use first-line treatments. Nitrofurantoin, TMP-SMX, and fosfomycin are the initial go-tos. However, specific drug recommendations should be dependent on the local antibiogram. An antibiogram is a periodic summary of antimicrobial susceptibilities that helps track drug resistance trends.
- Repeat testing. If UTI symptoms persist after antimicrobial therapy, clinicians should repeat the urinalysis, urine culture, and antibiotic susceptibility testing to help guide further management.
- Try vaginal estrogen. For peri- and post-menopausal women with recurrent UTIs, vaginal estrogen therapy is recommended to reduce risk of future UTIs.
Which Antibiotic Will Work Best
Your doctor will take a urine sample to confirm that you have a UTI. Then the lab will grow the germs in a dish for a couple of days to find out which type of bacteria you have. This is called a culture. Itâll tell your doctor what type of germs caused your infection. Theyâll likely prescribe one of the following antibiotics to treat it before the culture comes back:
Which medication and dose you get depends on whether your infection is complicated or uncomplicated.
âUncomplicatedâ means your urinary tract is normal. âComplicatedâ means you have a disease or problem with your urinary tract. You could have a narrowing of your ureters, which are the tubes that carry urine from your kidneys to your bladder, a narrowing in the urethra which transports urine from the bladder out of the body, or, you might have a blockage like a kidney stone or an enlarged prostate . It’s also possible you have a urinary fistula or a bladder diverticulum.
To treat a complicated infection, your doctor might prescribe a higher dose of antibiotics. If your UTI is severe or the infection is in your kidneys, you might need to be treated in a hospital or doctor’s office with high-dose antibiotics you get through an IV.
Your doctor will also consider these factors when choosing an antibiotic:
- Are you over age 65?
- Are you allergic to any antibiotics?
- Have you had any side effects from antibiotics in the past?
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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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Is It Safe To Treat Utis Without Antibiotics
Antibiotics are effective treatments for UTIs. Sometimes, the body can resolve minor, uncomplicated UTIs on its own, without antibiotics.
Complicated UTIs require medical treatment. These are some factors that can make the infection complicated:
- changes in the urinary tract or organs, such as a swollen prostate or reduced flow of urine
Use Of Antibiotics For Treating Utis In Dogs And Cats
JD Foster
VMD, DACVIM
Dr. Foster is an internist and Director of the Extracorporeal Therapies Service at Friendship Hospital for Animals in Washington, D.C. He has lectured around the world on various renal and urinary diseases and authored numerous manuscripts and book chapters on these topics. He is the current president of the American Society of Veterinary Nephrology and Urology.
Urinary tract infections are common in small animal practice it has been reported that up to 27% of dogs will develop infection at some time in their lives.1
Most UTIs are successfully treated with commonly used drugs, dosages, and administration intervals. However, infections can be challenging to effectively treat when they involve the kidneys and prostate . In addition, it can be difficult to create an appropriate antibiotic prescription in patients with kidney disease due to reduced drug clearance.
Understanding drug pharmacokinetics and pharmacodynamics is essential when determining the most effective antibiotic therapy. In addition, successful antimicrobial therapy requires appropriate choice of antibiotic, including dose, frequency, and duration .
Figure 1
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Treatment Length For All Utis
No matter what kind of bacterial infection you have and where its located, the best antibiotic treatment for UTI is generally the shortest one. This is to lower your odds of developing antibiotic resistance and to decrease your risk of a yeast infection or infectious diarrhea.
Still, its imperative that you take all the antibiotics prescribed, even after symptoms subside. Most UTIs resolve within three to 10 days. Stopping your antibiotics early, before the drugs eliminate all bacteria, can create a breeding ground for antibiotic-resistant bacteria, too.
Most Common Bacteria That Cause Utis
Based on a study by The National Center for Biotechnology Information, the bacteria most commonly associated with causing UTIs are:
- Escherichia coli
- Pseudomonas aeruginosa
Based on the symptoms the patient is experiencing and before any testing is done to officially determine the infection type, the doctor prescribes first line antibiotics. For most UTIs, the prescribed antibiotic will cure the infection and not require any further testing.
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Antibiotics For Uti: Whatre Your Options
If you are experiencing a urinary tract infection , you are not alone. Roughly 60% of women and 12% of men will have at least one UTI in their lifetimes. It is one of the most common outpatient infections in the United States.
Urinary tract infections begin when microbes enter the urinary system, overcome the bodys natural defense mechanisms, and multiply. For many patients, these infections can be uncomfortable.
Although fungi or viruses can cause some UTIs, bacterial microbes are the primary cause behind most infections. The best way to treat a bacterial UTI is to kill the germs causing the condition with antibiotics. Patients who take antibiotics for UTI conditions often report experiencing relief within just a few days.
Lets take a closer look at the different antibiotic options for UTI treatment.
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How Long Should I Take Antibiotics
Your doctor will let you know. Typically, for an uncomplicated infection, youll take antibiotics for 2 to 3 days. Some people will need to take these medicines for up to 7 to 10 days.
For a complicated infection, you might need to take antibiotics for 14 days or more.
If you still have symptoms after completing antibiotics, a follow-up urine test can show whether the germs are gone. If you still have an infection, youll need to take antibiotics for a longer period of time.
If you get UTIs often, you may need a prolonged course of antibiotics. And if sex causes your UTIs, youll take a dose of the medicine right before you have sex. You can also take antibiotics whenever you get a new UTI if youâre having symptoms and a positive urine culture.
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What Can I Do To Avoid Getting A Uti In The First Place
Women are more susceptible to U.T.I.s, as they are commonly known, owing to the way these germs infect: They often travel through fecal residue from the rectum to the urethra this can happen through sex or poor bathroom hygiene. Even taking great care does not make them entirely avoidable.
Here are some steps that can help prevent urinary tract infections: Drink plenty of fluids, which helps flush out the bladder. Empty your bladder after sexual intercourse. Practice good bathroom hygiene, which, simply put, means wiping from front to back.
During the reproductive years, women are as much as 50 times more likely than men to get a U.T.I. However, those numbers even out significantly in an aging population because men wind up getting surgical procedures, or have bowel control issues, that might lead to the same spread of germs from gut and rectum to the urinary tract.
Can Uti Symptoms Linger After Antibiotic Treatment
A urinary tract infection is an infection caused by bacterial growth that occurs in any part of the urinary tract, though most UTIs occur in the lower urinary tract .
This type of UTI is referred to as a simple, or uncomplicated, UTI. If the infection spreads to your upper urinary tract, it can cause a kidney infection.
In some cases, a kidney infection, also called pyelonephritis, can be life-threatening.
The most common symptom of a UTI is frequent urination, but signs can also include a burning or painful sensation when urinating, cloudy urine, blood in urine, back pain, and pelvic pain.
Women in menopause or postmenopause may sometimes have a UTI without experiencing any symptoms.
Its important to speak to a medical provider to determine whether you have a UTI, especially if its your first time experiencing symptoms.
In most cases, antibiotic treatment will clear the infection and resolve your symptoms within 3-10 days. There are some conditions, however, that can cause your symptoms to linger after treatment:
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Antibiotics That Shouldn’t Be A First Choice For Uncomplicated Utis
Other antibiotics appear to be overused, and some physicians may misuse non-recommended antibiotics as first-line treatments. Ciprofloxacin is used in 35% of uncomplicated UTIs, while levofloxacin is used in 2%. These antibiotics can be important treatments in some cases of more complicated UTIs, but can have dangerous side effects.
The U.S. Food and Drug Administration warns that the use of these drugs should be restricted because of their potentially disabling side effects involving tendons, muscles, joints, nerves and the central nervous system. Additionally, in many parts of the country, bacteria commonly causing UTIs are becoming resistant to these antibiotics.
Is It Possible To Prevent Urinary Tract Infections With Diet And Supplements
It is possible to reduce the chance that a UTI will develop with dietary methods and some supplements but prevention of all UTIs is unlikely with these methods.
- Supplements such as eating cranberries, taking vitamin C tablets, and eating yogurt and other substances also may reduce the chance that a UTI will develop .
- However, as stated in the prevention section, changes in a person’s lifestyle may reduce the chance of getting a UTI as good as, if not better than, any diet or supplement.
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Antibiotics Used For Complicated Utis
Before getting into how to best treat a complicated UTI, its important to understand which UTIs are considered complicated. Here are some guidelines:
- Urinary tract abnormalities are present
- Youre pregnant
- The patient is a child
- A comorbidity is present that increases risk of infection or treatment resistance, such as poorly controlled diabetes
- Youre a man, since most UTIs in men are considered complicated
Kidney infections are often treated as a complicated UTI as well, notes the Merck Manual.
If a UTI is complicated, a different course of antibiotics may be required. And the initial dose of antibiotics may be started intravenously in the hospital. After that, antibiotics are given orally at home. In addition, follow-up urine cultures are generally recommended within 10 to 14 days after treatment. Not all of the antibiotics approved for uncomplicated UTIs are appropriate for the complicated version. Some that are considered appropriate, include:
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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Are There Natural At
Yes. While taking antibiotics is still considered the gold standard of UTI treatments, there are some things you can do at home that help relieve symptoms, as well. These include:
- Drink plenty of water. Consuming at least six to eight 8-ounce glasses of water daily can help flush away UTI-causing bacteria, setting you up for a quicker recovery. Plus, the more you drink, the more youll have to urinate.
- Urinate often. Each time you empty your bladder, youre helping to flush bacteria out of your system.
- Try heat. Applying a heating pad to your pubic area for 15 minutes at a time can help soothe the pressure and pain caused by UTI-related inflammation and irritation.
- Tweak your wardrobe. Wearing loose cotton clothing and underwear can help you recover from a UTI.
- Go fragrance-free. Make sure your personal hygiene products are fragrance-free to sidestep further irritation, notes the National Institute of Diabetes and Digestive and Kidney Diseases.
- Cut out certain irritants. Caffeine, alcohol, spicy food, raw onions, citrus fruits, carbonated drinks, artificial sweeteners, and nicotine can further irritate your bladder, making it more difficult for your body to heal, per the Cleveland Clinic.
Urine Drug Concentration & Clinical Efficacy
Antimicrobial drugs must achieve an adequate urine concentration, which must be maintained for a sufficient time for a drug to be effective in treating UTI.16 It has been suggested that clinical efficacy is observed when the urine drug concentration is maintained at a concentration 4-fold higher than the isolates MIC throughout the time between doses.9
Experimental studies in rats have shown that the time for which the plasma drug concentration exceeds the isolates MIC correlates to the magnitude of bacterial colony count reduction the longer the time for which the drug concentration remained above the MIC, the lower the urine colony counts.12 Successful eradication of bacteria within the renal parenchyma or urinary bladder wall is correlated to the plasma, not urine, drug concentration.
When prescribing time-dependent antibiotics, shortening the interval between drug administration is the most effective method to allow the tissue/urine drug concentration to exceed the MIC for the majority of the dosing interval.
- Drug elimination follows first-order kinetics, where 50% of the drug is lost in 1 half-life.
- In contrast, doubling the dose would only add 1 half-life to the dosing interval.
- To add 2 half-lives to the dosing interval, the initial dose would have to be increased 4-fold. The peak serum drug concentration achieved by this approach may exceed the window of safety, producing adverse drug effects.
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