Carefully Targeted Antibiotic Treatment For Urinary Tract Infections
So what do we do now? As a society and as individuals, we should reduce and carefully target antibiotic use. Both physicians and patients should be aware of the grave potential to lose effective antibiotics for all infections even simple UTIs. Its an opportunity that empowers individuals to have informed conversations with their doctors. Every time your doctor prescribes an antibiotic, ask: Do I need this? Why? Is there an antibiotic-free alternative? Talking about it might be enough to meaningfully reduce inappropriate antibiotic use.
If youre having UTI symptoms like burning with urination, more frequent urination, bloody or cloudy urine, low abdominal pain, or fever, you should see a medical provider to get tested. Youll have to urinate into a container and the medical office will test for products of bacterial metabolism. Make sure to tell your provider if youve had UTIs before, and what antibiotic you took. If you have a history of antibiotic-resistant infections, share that, too. There are alternatives to Cipro and Bactrim, but antibiotic choices are limited.
If antibiotic resistance continues to grow, more people will need intravenous treatment for UTIs we used to cure with simple oral antibiotic courses. Were also likely to see more complications, like kidney infections and sepsis, arising from ineffective treatment.
How Long Does It Take To Cure A Uti With Antibiotics
How long it takes to fully cure a UTI with antibiotics depends on the severity of the infection, the location of the infection, and how well your immune system functions. The following are rough estimates for treatment time:
- Lower UTI in otherwise healthy women: 3 to 7 days of antibiotics
- Lower UTI in otherwise healthy men: 7 to 14 days of antibiotics
- Lower UTI in people with diabetes or who are immunocompromised: 7 to 14 days of antibiotics
- Lower UTI in otherwise healthy pregnant women: 7 to 14 days of antibiotics
- Mild kidney infection in otherwise healthy people: 7 to 14 days of antibiotics
- Severe kidney infection: may take 14 days of antibiotics or longer and could require hospitalization
Why Your Uti Test May Be Negative Even When You Have Symptoms
How about a study that looked at bacterial DNA in the urine of women with UTI-like symptoms who also had a negative culture test?
To summarize, the researchers looked at urine samples of women without symptoms and a group with UTI-like symptoms. They performed two tests: a culture test and a DNA-sequencing test that allows identifying if there is any bacterial DNA in the urine.
According to the study, 90.5% of symptomatic women with a negative urine culture tested positive for Escherichia coli bacteria with molecular methods compared to about 5.3% of women without symptoms.
This allowed the researchers to conclude that culture tests might not be sufficiently accurate and if a patient complains of urinary tract infection symptoms, she might as well be treated for an acute UTI.
The findings are gaining traction among chronic UTI sufferers who feel that the study finally gives more credibility to their complaints.
However, argues Dr. Hawes the significance of finding bacterial DNA may be different than the significance of finding live growing bacteria. Does the DNA stay around after an infection? If so, for how long? How do you determine antibiotic sensitivity based on DNA findings rather than live growth?.
As Dr. Hawes concludes, We dont yet understand the clinical significance of this data. In other words, do not dismiss the results of your culture test because of this study.
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What Do I Do If I Have A Question About Antibiotic
If your question is about your own health, please contact your GP or medical specialist treating you.
If you are feeling unwell but the problem is not a medical emergency, call 111 to find out whether you need to attend hospital.
If you are experiencing a health emergency, you should call 999 or attend your nearest accident and emergency, taking all of your medications with you.
If you are not seeking health advice, but would like to talk to someone who understands antibiotic resistance and can help you find more information, get in touch with our Patient Support Officer, Arlene.
Contact Arlene on or call her on 07367 784114. Calls are charged at your usual mobile or landline rate. However, you can request a call back from Arlene by text, email or by leaving a message.
When To Get Medical Advice
It’s a good idea to see your GP if you think you might have a UTI, particularly if:
- you have symptoms of an upper UTI
- the symptoms are severe or getting worse
- the symptoms haven’t started to improve after a few days
- you get UTIs frequently
Your GP can rule out other possible causes of your symptoms by testing a sample of your urine and can prescribe antibiotics if you do have an infection.
Antibiotics are usually recommended because untreated UTIs can potentially cause serious problems if they’re allowed to spread.
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The Problems With Frequent Antibiotic Use
Our own research has shown that many females with recurrent UTIs have taken the same antibiotic for years. For some this can mean every few weeks for others every few months.
|My doctor just calls in a prescription for the same antibiotic to whichever pharmacy I need them at, then I collect them. When Im overseas I stock up on cheap antibiotics if I can get them. Ive been taking the same antibiotic at least 15 years.|
The longer you suffer from recurrent UTIs, the muddier the waters of UTI treatment antibiotics can seem. After all, if the treatment options youve tried have failed to prevent further UTIs, are any of them really working?
For many people, taking UTI antibiotics frequently is concerning. Yet without having found an effective alternative, antibiotics are still their first port of call at the onset of a UTI.
On a basic level, frequent antibiotic use means organizing multiple prescriptions, planning ahead and spending money. But there is also serious concern around antibiotic-resistant superbugs, destroying your gut flora, and whether frequent antibiotic use even helps.
And as we mentioned in our section on what causes UTIs, there is enough evidence to suggest that ineffective antibiotic use could be a major contributor to the formation of chronic infection, embedded in the bladder wall.
Frequent antibiotic use that does not effectively treat chronic infection, can result in increased bacterial resistance, which again makes treatment more difficult.
Uti Antibiotics Resistance Rates
The breakdown of causes of urinary tract infections is not the same the world over.
While the same major groups of bacteria are generally identified everywhere, the percentage of infections caused by each, and the resistance of each to particular antibiotics is often different, depending on the region.
To put it simply, an antibiotic that is considered effective in one region may be considered less effective in another.
For this reason, each region has its own recommendations for first line antibiotics for urinary tract infections.
As we covered above, doctors use these recommendations to select which antibiotic to prescribe in the absence of conclusive test results. Recommendations change over time as bacterial resistance and prevalence changes. So medical practitioners need to keep up with the latest information.
Its a tough job keeping up, and in reality, it is thought that up to 50% of antibiotic prescriptions in the United States continue to be unnecessary or inappropriate. This figure applies not only to UTI antibiotics, but to all prescriptions for antibiotics.
Check out our expert video series to learn more about antibiotic resistance in chronic UTI.
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Can I Change Uti Antibiotics
The probability that the first line antibiotic will be effective is relatively high. But what happens if UTI antibiotics dont work?
This is where that sample that was sent off for testing should help.
In the event your symptoms are not reduced, the lab test should identify which antibiotic will work better. In order to identify which antibiotic is likely to be effective, antibiotic susceptibility testing is conducted.
What is antibiotic susceptibility?
Simply put, antibiotic susceptibility is a measure of how sensitive a particular type of bacterium is to a particular antibiotic, or to a range of different antibiotics.
Antibiotic susceptibility testing is the practical application of this. In the lab, different antibiotics are physically applied to the bacteria found in your sample. This is then observed, and it is noted whether the antibiotic inhibits the growth of the bacteria, and if so, by how much.
The results of an antibiotic susceptibility test can help your doctor choose which antibiotic to recommend, particularly when the first round of treatment failed.
Although antibiotic susceptibility testing is helpful in theory, if youve read our section on testing, youll know that this process is not foolproof. And if an infection has become chronic or embedded, even a short course of the right antibiotic will not address the underlying infection.
Bacteria Hide In Your Bladder Lining
One interesting fact from Dr. Hawes: during bladder cystoscopy of chronic UTI patients she frequently sees pimples on their bladder surface. The correct medical term is Cystitis cystica, which is a benign lesion of the bladder as a result of chronic inflammation.
These pimples are thought to be caused by chronic irritation of the urothelium because of infection, calculi, obstruction, or tumor.
Per Dr. Hawes, a biopsy of these pimples typically comes back with results of bacterial contamination. Basically, bacteria comfortably reside inside of these pimples on a bladder wall. The worst thing, they can reappear from time to time to cause yet another infection. Thats why you notice that UTI symptoms come back after antibiotics.
If thats the case, Dr. Hawes identifies the type of bacteria via a culture test and which antibiotic bacteria are susceptive to. After that, she combines short-term intensive antibiotic therapy with long-term low dose antibiotics. This normally kills bacteria that keep reappearing out of the cysts into your bladder.
Many thanks to Dr. Lisa Hawes who took the time off her weekend to share these insights. We hope this information will help you when discussing a treatment plan with your urologist. And if you are happened to be in Maryland, here is the contact information for Dr. Hawes practice.
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When Should Symptoms Disappear
The length of treatment for your symptoms will depend on the cause.
If your doctor confirms that you have a simple UTI, expect symptoms to disappear within 3-10 days. If your doctor says your UTI is more severe, it may take several weeks for the infection to clear and your symptoms to disappear.
If the cause of your symptoms is unrelated to a UTI, talk to your doctor about the recommended treatment plan and when you can expect your symptoms to disappear.
Regardless of the cause of your symptoms, if your doctor prescribes a course of antibiotics for the treatment of your symptoms, its important that you complete the full course of medication as directed.
An Ounce Of Prevention
Unfortunately, most UTIs are not completely preventable, and are caused by differences in the structure or function of the urinary tract and immune system. But there are things you can do to keep healthy. For example, stay hydrated to increase urine production and flush out unwanted bacterial intruders. Good hygiene is also important, but scrubbing away at delicate genital tissues can damage them and create portals for bacteria. Clean your genital area gently with mild soap and water. Postmenopausal women may benefit from vaginal estrogen cream. Finally, eating cranberries and urinating after having sex havent been proven to have major benefits, but arent likely to hurt, either.
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About the Author
Lisa Bebell, MD, Contributor
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What If I Have Frequent Recurring Utis
Within a year of havig a UTI infection, roughy one-quarter to one-half of women will have another UTI. For these women antibiotic prophylaxis may be recommended by her health care provider. With a recurrent course of UTIs, a urine culture or imaging tests may be required for further analysis.
For recurrent UTIs, there are several antibiotic options for prevention:
- A shorter course of antibiotics at the first sign of UTI symptoms a prescription may be given to you to keep at home.
- A longer course of low-dose antibiotic therapy.
- Take a single dose of an antibiotic after sexual intercourse.
The choice of antibiotic is based on previous UTIs, effectiveness, and patient-specific factors such as allergies and cost. Antibiotics commonly used for recurrent UTIs can include sulfamethoxazole-trimethoprim, nitrofurantoin, cefaclor, or cephalexin.
In postmenopausal women with vaginal dryness that may be leading to recurrent UTIs, vaginal estrogen may be an effective treatment. Treatment options your doctor might recommend include: Estring, Vagifem , or vaginal estrogen creams .
Can You Test For Interstitial Cystitis
At a certain point, when UTI tests fail to identify a bacterial cause for symptoms, a diagnosis of recurrent UTI is escalated to IC for many individuals.
We know standard UTI testing methods are inaccurate. So there is a good chance a significant number of people are misdiagnosed with IC after receiving a false-negative on their test results. They may have an infection that testing has simply failed to pick up.
|I was told my urine culture was negative, and I therefore didnt have an infection. I was subsequently diagnosed with IC, but occasionally, during a symptoms flare, I would be culture positive. Eventually I pursued better testing, and found Id probably had an infection the whole time. Im slowly recovering, with treatment, and Im glad I didnt accept my diagnosis in the end.|
A number of researchers now believe many cases of Interstitial Cystitis may indeed be caused by bacteria that standard UTI testing has failed to identify.
Read more about Interstitial Cystitis and chronic infection testing and treatment in a dedicated section from our interview with Ruth Kriz.
If you have received inconclusive or negative test results, despite symptoms of a UTI, we encourage you to keep pushing for an answer. Seek better testing and find a practitioner who is willing to work with you.
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Option #: Uti Symptoms Return After Antibiotics
Another story is when your urine test did show a UTI. You then took antibiotics, felt completely fine, but several days later woke up with the same nasty UTI symptoms.
Here two options are possible: we were unable to eliminate the infection completely or it is reinfection, says Dr. Hawes if only 2-3 days elapsed since treatment and symptoms recurred, most likely we were not able to clear the infection. However, if you get an infection 2-3 weeks after your last antibiotic treatment, count it as reinfection.
Why Is My Dog’s Urinary Tract Infection Uti Not Getting Better
When a dog gets a urinary tract infection, a course of antibiotics is prescribed as a treatment, and therefore, it can be concerning when a dog’s urinary tract infection is not getting better despite such treatment. It’s important to follow up with your veterinarian if this is what you are dealing with considering that normally a course of antibiotics is all that is needed to treat this type of infection. It’s therefore normal wondering “why is my dog’s urinary tract infection not getting better despite using antibiotics? ” There may be several reasons for a dog not getting better and most of them require veterinary evaluation.
A Matter of Time
Defeating a urinary tract infection may take some time and it’s important to monitor the dog carefully to determine whether the dog is feeling better or not.
Dogs with a urinary tract infections often show signs of increased urination, straining and licking private parts. There is also often presence of blood in the dog’s urine. Generally, after starting antibiotics, dog owners should start seeing some signs of improvement.
After how many days on antibiotics should a dog show signs of recovering from a urinary tract infection? Generally, for a dog urinary tract infection, antibiotics take 3 to 5 days to start killing the infection, explains veterinarian Dr. Drew.
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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.
Otc Uti Treatment Options
UTIs are typically treated with a course of antibiotics that may run for a single day or a course of 7 days but usually lasts at an average of 1-3 days for uncomplicated urinary tract infections. However, some infections might not even need a course of antibiotics and may cease to exist. But, while treatment of UTIs without antibiotics may be a possible prospect in the future, for now, only a few equally effective OTC UTI treatments are available that can help a patient manage their symptoms. These include:
Hydration: Although not exactly an OTC UTI treatment method, hydration is still the key to treating a UTI quickly. If youve contracted a UTI, it is important to have fluids as frequently as possible so that you urinate more frequently and the harmful bacteria are flushed out of your urinary tract through natural means. This option means curing your symptoms without the use of medication.
- Probiotics: Probiotics serve as an excellent OTC UTI treatment option that helps promote digestion and immunity in your body. Probiotics restore the good bacteria present in your gut and reduce the chances of reinfection.
- Ascorbic Acid: Increasing your Vitamin C intake not only strengthens your immune system but is also a greater OTC UTI treatment option since it helps acidify the urine which may reduce the chance of reinfection.
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