A urinary tract infection (UTI) is a bacterial infection that occurs anywhere in the urinary tract -- including the urethra (urethritis), bladder (cystitis), and kidney (pyelonephritis). These infections are among the most common urological conditions, with cystitis occurring most frequently, and both women and men are susceptible. As many as 60 percent of all individuals will have a urinary tract infection at some time in their lives. Treatments for cystitis are outlined below.
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 present—such as a burning sensation during urination or an increased need to urinate—treatment 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 (7 days), 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.
- Penicillin or amoxicillin: These antibiotics are usually only prescribed if other antibiotics have proven ineffective. Bacteria, particularly E. coli, have become resistant to penicillin and amoxicillin and only respond about 50 percent of the time. Side effects include diarrhea, nausea, vomiting and vaginal itching or discharge.
Treatment for UTI Symptoms
When UTI symptoms are particularly uncomfortable, a physician may also recommend phenazopyridine (Pyridium) to alleviate the burning and discomfort to be taken in conjunction with antibiotics. This medication should not be taken for more than two days and has side effects that include headache, nausea, and changes in urine color (orange).
Recommendations for UTI Prevention
To prevent urinary tract infection, some research suggests that the following may be helpful:
- Increasing fluid intake: The doctor may recommend increased fluid intake to help flush bacteria out of the urinary system.
- Drinking cranberry juice: Drinking 8 ounces of cranberry juice a day may help prevent recurrent UTIs. People who take blood thinners such as warfarin (Coumadin) or are prone to kidney stones should check with a physician before trying this approach.
- Proper hygiene: Regular bathing keeps the genital area bacteria free, and women should wipe front-to-back after using the bathroom so as to avoid introducing bacteria into the urethra.
Treatment of Recurrent UTIs
Some people develop recurring urinary tract infections and may require further testing to determine the cause. Treatment may include longer doses of antibiotics or more potent doses of antibiotics delivered intravenously. Recurrent UTIs may be a symptom of a more chronic problem (such as hydronephrosis) and require further examination by a trained urologist.
References
Couling, R. (2008). Managing lower UTI in adults in the community. Nurse Prescribing. 6(11), 485-489.
Huang, C.-H. et al. (2012). Cranberry-Containing Products for Prevention of Urinary Tract Infections in Susceptible PopulationsA Systematic Review and Meta-analysis of Randomized Controlled Trials. Archives of Internal Medicine. 172(13):988-996.
O’Shea, L. (2010). Diagnosing urinary tract infections. Practice Nurse. 40(9), 20-25.
Riley, J. (2012, September 1). Urinary tract infection. Conditions and Procedures in Brief, 1-3.
Stapleton, A.E. et al. (2012). Recurrent Urinary Tract Infection and Urinary Escherichia coli in Women Ingesting Cranberry Juice Daily: A Randomized Controlled Trial. Mayo Clinic Proceedings. 87(2):143-150.
Urinary tract infection. (2012). Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/urinary-tract-infection/DS00286.
Urinary tract infection—Causes. (2011). University of Maryland Medical Center.
Urinary tract infections in adults. (2012). National Kidney and Urologic Diseases Information. Publication No. 12–2097.
