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Home >> Women's Health >> Urinary Tract Infection >> Treatment
 Urinary Tract Infection - Treatment
Overview | Diagnosis | Treatment | FAQ
Symptomatic bacterial infections are treated with antibiotics. If the infection is
treated promptly, a three-day course of antibiotics is as effective as a seven to ten-day
course of medication. Furthermore, a shorter course of therapy costs less and causes
fewer side effects such a diarrhea or vaginal yeast infection compared to a longer course
of treatment. Options for treating uncomplicated urinary tract infections include one or
more of the following:
Self-directed therapy:
According to scientific studies, women can accurately
diagnose a UTI based on symptoms alone. Researchers reported that 84% of urine
cultures showed an infection and 11% of specimens showed pus cells or bacteria when
women experienced UTI symptoms.
If women can identify when they have a UTI and the infection responds to a
three-day course of antibiotics, then self-directed therapy is a viable option for treating
subsequent infections. The routine is as follows: At the first onset of UTI symptoms,
women take an antibiotic and continue therapy for three days. The choice of antibiotics
varies, but may be either Macrodantin 50 mg four times daily, Macrobid 100 mg twice
daily, Septra DS one tablet twice daily, or a fluoroquinolone such as Cipro 500mg (one
half or one pill) twice daily, Cipro XR 1000mg once daily, or Levaquin 500mg (one half
or one pill) once daily. Yearly office visits are required before another twelve-month
prescription for antibiotics will be written.
If symptoms persist despite antibiotic therapy, it may be caused by a ‘break
through’ infection. Three quarters of subsequent infections are caused by a different
strain of bacteria. Although most of these bacteria will respond to the chosen antibiotic,
bacteria can develop resistance, especially if antibiotics are used frequently. If an
antibiotic other than a fluoroquinolone has been routinely used for self-directed therapy,
additional treatment with a three-day course of a fluorquinolone will usually eradicate the
break through infection. If symptoms persist though, or frequent break through infections
occur, a repeat office visit is recommended. In this situation, antibiotics should be
stopped for at least 24 hours before coming in for visit to allow sufficient time for
antibiotics to be cleared from the system, especially if once-a-day antibiotics have been
used, since residual antibiotics will interfere with the urine culture results. A mid stream
or catheterized urine culture will help sort out whether lingering symptoms are due to
inflammation versus a resistant bacterial organism.
Antibiotic after sex:
If UTIs occur after sexual intercourse, taking a single antibiotic after sex can
prevent recurrent urinary tract infections. Alternatively, self-directed therapy may
require fewer antibiotics in the long run, depending upon the level of sexual activity and
number of yearly infections.
Continuous antibiotic suppression:
If infections occur more than 4 times yearly, taking one quarter of the normal
dose of antibiotics either nightly or every other day can prevent infections by 95% as
long as the antibiotics are continued. However, once the antibiotics are stopped, UTIs
will usually reoccur.
When not to treat a UTI:
Approximately 3.5% of the general population has bacteria in their urine without
symptoms. The incidence of asymptomatic bacteriuria increases with age and affects 15-
20% of women aged 65-70 and 20-50% for women older than 80 years. Furthermore, it’s
not unusual for female children and patients with diabetes or spinal cord injuries to have
asymptomatic bacteriuria. Antibiotic treatment is not only unnecessary in this situation, it can actually make matters worse. Treating asymptomatic bacteriuria with antibiotics
increases the risk of developing a serious kidney infection.
Prevention:
Scientific research has shown that the use of spermicides adversely affects the
vaginal ecosystem and increases the risk of recurrent UTIs. Consumption of eight ounces
of unsweetened cranberry juice daily or taking a cranberry extract pill three times daily
can also decrease the incidence of recurrent UTIs.
Unproven, but common sense measures that may decrease the incidence of
recurrent UTIs include drinking at least 64 ounces of water daily, wiping after urination
from front to back, urinating after sexual intercourse, and avoiding chemical douches.
Urinary irritants such as caffeine and consumption of hot and spicy foods won’t
cause a UTI but they can provoke symptoms that mimic ‘cystitis’. Keeping a diary of
food and beverage consumption during symptomatic episodes can help identify triggers.
Stress is another common cause of bladder symptoms. Stress activates the adrenal glands
to release adrenaline – the ‘fight-or-flight’ hormone- that in turn stimulates the nerves
that cause the bladder to become overactive.
Taking a probiotic such as acidophilus twice daily with food whenever antibiotics
are taken and for several weeks thereafter can help prevent antibiotic-related side effects
such as abdominal bloating, diarrhea, and vaginal yeast infection. Probiotics should be
refrigerated after the bottle is opened.
Click here to download a PDF with information about Probiotics.
Click here to download a PDF on Female Recurrent Urinary Tract Infections.
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