When You Need Themand When You Dont
Antibiotics are medicines that can kill bacteria. Doctors often use antibiotics to treat urinary tract infections . The main symptoms of UTIs are:
- A burning feeling when you urinate.
- A strong urge to urinate often.
However, many older people get UTI treatment even though they do not have these symptoms. This can do more harm than good. Heres why:
Antibiotics usually dont help when there are no UTI symptoms.
Older people often have some bacteria in their urine. This does not mean they have a UTI. But doctors may find the bacteria in a routine test and give antibiotics anyway.
The antibiotic does not help these patients.
- It does not prevent UTIs.
- It does not help bladder control.
- It does not help memory problems or balance.
Most older people should not be tested or treated for a UTI unless they have UTI symptoms. And if you do have a UTI and get treated, you usually dont need another test to find out if you are cured. You should only get tested or treated if UTI symptoms come back.
Antibiotics have side effects.
Antibiotics can have side effects, such as fever, rash, diarrhea, nausea, vomiting, headache, tendon ruptures, and nerve damage.
Antibiotics can cause future problems.
Antibiotics can kill friendly germs in the body. This can lead to vaginal yeast infections. It can also lead to other infections, and severe diarrhea, hospitalization, and even death.
Antibiotics can be a waste of money.
When should older people take antibiotics for a UTI?
When Do Symptoms Of A Uti Go Away With Antibiotic Treatment
Once you start taking antibiotics, symptoms of a lower urinary tract infection typically resolve within 24 to 48 hours. With a kidney infection, you can expect to begin feeling better in 3 to 7 days. You will likely find that your symptoms go away before you finish taking the course of antibiotics prescribed by your doctor. This doesnt mean that your infection is gone. Continue taking the medication as directed until you have used all of it to ensure you fully eliminate the bacteria.
How To Tell The Difference Between Asymptomatic Bacteriuria And A Uti
By definition, in asymptomatic bacteriuria, there should be no UTI symptoms present.
The following signs and symptoms can be caused by UTI:
- Burning or pain with urination
- Increased frequency or urgency of urination
Whether or not an older person has a clinical UTI, the urine dipstick may be abnormal, in part because certain abnormal results suggestive of UTI may in fact only reflect bacterial colonization of the bladder. So one should not rely on urine dipsticks or related urine analysis tests as the sole justification for diagnosing a UTI. Symptoms are necessary!
The thing is, some older adults may only show vague or non-specific symptoms when they get a UTI, such as confusion or weakness. This is especially true of aging adults who are frail, or are quite old, or have Alzheimers or another dementia.
For this reason, it can be difficult to determine whether a frail or cognitively impaired older person is having UTI symptoms that warrant treatment.
Experts are currently debating whether its justified to treat for possible UTI, for those cases in which an older person with asymptomatic bacteriuria shows signs of delirium, but no other UTI symptoms.
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Uti Antibiotics: Treatment For Urinary Tract Infection
Special Announcement , 2022:
What are the best UTI antibiotics? What happens if antibiotics dont work? Can you treat a UTI without antibiotics?
Here is where we lay out everything you need to know about UTI antibiotics. If youve ever googled questions like
Should I take Amoxicillin for UTI?What are the best antibiotics for UTI?Is Macrobid for UTI appropriate?What happens if antibiotics dont work for UTI?Can you treat a UTI without antibiotics?
This article is for you. Even if you havent googled any of these, but have questions about antibiotics for UTI, this should have you covered.
Jump To Section:
- How UTI antibiotics are selected. > > > >
- What happens if antibiotics dont work for UTI? > > > >
- My UTI test results are negative, what now? > > > >
- Do I have recurrent UTI or Interstitial Cystitis? > > > >
- Can you break the UTI antibiotic treatment cycle? > > > >
We find people discuss UTI antibiotics as though this represents a single treatment option. In reality, UTI antibiotics refers to a whole range of different drugs and doses, selected for specific reasons.
Knowing why certain antibiotics are helpful and others arent will give you more control over your own treatment. So lets start at the very beginning. That way you can confirm the knowledge you already have, then expand on it.
Chronic Or Recurring Utis
Some people get UTIs more often than others. They might have UTIs that last a long time or that come back more than 3 times in a year .
You might have heard that cranberry juice or cranberry pills can help if you get UTIs a lot. Some studies have tested whether cranberry products with the fruit sugar D-mannose benefit people who get UTIs. More research needs to be done to see how well they work.
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Reasons Why Antibiotics Did Not Resolve Your Uti Symptoms
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I took antibiotics for UTI but symptoms are still there, its a common complaint among chronic UTI sufferers but it could mean a lot of different things. I askedDr. Lisa Hawes a urologist at Chesapeake Urology to help to navigate different case scenarios and discuss what they could potentially mean. However, do not attempt to self-treat based on this information only.
This post should rather serve you as a guide for a conversation with your doctor. When you know what to mention during your doctor visit, you have higher chances to get better care.
Antibiotic Overuse Leads To Antibiotic Resistance
At some point, most people have taken a course of trimethoprim/sulfamethoxazole or ciprofloxacin , two common antibiotics used for UTIs. However, in the last few years it has become clear that the likelihood these antibiotics will kill most UTIs is dropping rapidly. You may have read the recent, frightening New York Timesarticle reporting one in three uncomplicated UTIs in young healthy women are Bactrim-resistant and one in five are resistant to five other common antibiotics. Pretty scary, since we used to feel confident that writing a prescription for Bactrim was a sure recipe for cure.
How is it that we are losing the antibiotic war with bacteria? Though many things drive bacterial resistance, giving antibiotics to animals and antibiotic overuse in humans top the list.
We use a lot of antibiotics in humans too much, and not always for the right reasons. When we prescribe antibiotics for viral illnesses like a cold, the flu, or common sinusitis, we create a massive shift in the bodys bacteria for no good reason .
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Are Urinary Tract Infections Contagious
You cannot pass a UTI on to another person. However, if you have an infection of any type particularly one that is antibiotic resistant there is always a risk that the bacteria causing the infection could infect those around you if you do not adhere to proper hygiene standards. If you have an ESBL resistant infection, you will often be kept in isolation in a hospital ward, to decrease the risk of spreading these bacteria to other vulnerable patients. For prevention of UTIs, it is particularly important that you wash your hands after using the bathroom and after sexual contact, and maintain a clean environment.
Find out more about what you can do to prevent the spread of harmful bacteria.
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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Do I Have Recurrent Uti Or Interstitial Cystitis
One study found that 74% of females with Interstitial Cystitis had previously been diagnosed with recurrent UTI.
The diagnosis of a single UTI becomes a diagnosis of recurrent UTI once you have experienced at least three UTIs in the last 12 months or at least two within the previous 6 months.
A diagnosis of recurrent UTIs can be indefinite. Weve interviewed people who have been diagnosed with recurrent UTIs for more than 20 years, with their treatment never changing.
|Im not even sure if the antibiotics are helping, or if its just because I drink a bunch of water and it flushes the UTI out. They definitely used to work, but now I think, if my UTIs keep coming back, maybe the antibiotics arent really working at all?|
Some females report a recurrence every time they have sex. Others find it happens when they feel particularly dehydrated, or after intense exercise. And then there are the recurrences that dont seem linked to anything except time. Some individuals suffer the symptoms of an acute UTI every 4-8 weeks, like clockwork.
In the absence of positive test results, many females will go on to be diagnosed with Interstitial Cystitis . Depending on the knowledge of your medical practitioner and your own research, you may or may not have heard of this term.
The last part of that definition is important. It implies that IC can be diagnosed once UTI test results come back negative. That in itself is a little scary.
Can Uti Symptoms Linger After Antibiotics
Though most UTIs are effectively treated with antibiotics, in some cases, UTI symptoms can linger even after completing the full course of antibiotic medication prescribed by your doctor.
In this article, Ill describe the possible causes of lingering UTI symptoms after antibiotics.
Ill also cover the recommendations for what to do when UTI symptoms linger after treatment, and when you should expect your symptoms to disappear.
Finally, Ill explain when its important to reach out to your doctor or healthcare provider for testing or a more thorough exam.
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I Still Have A Uti After Finishing A Course Of Antibiotics Why Didn’t Drug Kill It All Off
I’m 25 and not sexually active. After having a burning discomfort down there and lower back pains that my doctors were ignoring for weeks to months they finally did a test and discovered I had a UTI. I was put in Macrobid/ nitrofutonin 100mg 1 pill twice a day for 5 days. I took the medicine EXACTLY as prescribed. I was drinking both cranberry juice and water to flush it out completely. I did notice an immediate difference in the pain when I was taking the antibiotics. However, by the 4th day of treatment I noticed My infection stopped responding to the antibiotics. So I just assumed maybe it’s residual burning and irritation from having a UTI for awhile. Plus I thought once I finish the course maybe it needed time to kick in so waited a few weeks to see if there would be difference.
1 like, 114 replies
Posted 6 years ago
You may need a different antibiotic. I, too, was on the nitrofutonin, and it didn’t get rid of it. The dr. prescribed Amoxicil which took care of it. In the past, I have also been prescribed Cipro which would knock it out fast. The last infection i had which was about 2 months ago, was really hard to get over. I ended up having an ultrasound/ cystoscopy which were normal. The symptoms remained yet no infection. My urologist seems to believe I may have had an allergic reaction to the lubricant used f/ my pap smear. I am just now beginning to feel better.
When Uti Treatment Is Necessary
If youre experiencing multiple symptoms of a UTI and we have confirmed that you have abnormal bacteria growth in the urinary tract, antibiotics usually are the most effective way to fight off the bacteria. The dosage and type of antibiotics you take depend on the severity of your infection. Make sure to speak to your doctor about your particular situation and what medication would be best for you.
If youre experiencing recurrent UTIs , your doctor will likely suggest you undergo screenings to identify any potential abnormalities in the body that could be contributing to your UTIs. One such screening is a cystoscopy, in which a doctor uses a thin tube called a cystoscope to examine your urethra and the lining of your bladder.
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How Common Is Asymptomatic Bacteriuria
Asymptomatic bacteriuria is more common in older adults than many people including practicing clinicians may realize:
- In women aged 80 or older, 20% or more may have this condition.
- In healthy men aged 75 or older, 6-15% have been found to have bacteria with no UTI symptoms.
- Studies of nursing home residents have found that up to 50% may have asymptomatic bacteriuria.
This condition also affects 2-7% of premenopausal women, and is more common in people with diabetes.
Asymptomatic bacteriuria becomes more common as people get older, in part because it is related to changes in the immune system, which tends to become less vigorous as people age or become frailer.
Studies have found that in older adults, asymptomatic bacteriuria does sometimes go away on its own, but it also often comes back or persists.
How Long Does It Take To Cure A Uti Without Antibiotics
If you dont take a prescription antibiotic for UTI treatment, your infection will likely last longer than the time frame listed above. Generally, you should see a doctor if you begin to develop UTI symptoms that persist for longer than two to three days. Without treatment, a minor infection of the lower urinary tract could spread to your kidneys, putting you at risk for organ damage and serious blood infections.
Signs that a lower UTI has become a kidney infection include:
If you experience any of these symptoms, seek prompt medical attention.
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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
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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What Causes Uti Symptoms To Linger Even After Antibiotic Treatment
Antibiotic resistance occurs when the bacteria causing your UTI dont respond to the administered antibiotics, often because of frequent use.
This is especially true for people who have chronic UTIs. When antibiotics are used frequently or constantly, the bacteria may evolve and become resistant to them.
E. coli is the most common bacteria that causes UTI. However, if your UTI is caused by a less common bacteria strain, or even a virus or fungi, there is a chance that the antibiotic prescribed to treat the infection is not the right one and therefore ineffective.
For people who dont respond to the standard therapy for E. coli, a urine culture may be necessary to look at what is causing the UTI.
Sometimes, UTI symptoms dont resolve with antibiotics because it turns out you dont have a UTI at all, but instead a condition that causes UTI-like symptoms. These conditions may include: