UTI Medicine: Diagnosis, Treatment & Care Guide

A urinary tract infection (UTI) can cause burning when passing urine, frequent urination, an urgent need to urinate and discomfort in the lower abdomen. Most UTIs affect the bladder, but an infection can also spread to the kidneys and require prompt treatment.

The right UTI medicine depends on where the infection is, how severe it is and your individual health needs. This guide explains how UTIs are diagnosed, which treatments may be used, how to manage symptoms at home and when medical attention is needed.

A UTI occurs when bacteria enter the urinary tract and multiply. The urinary tract includes the urethra, bladder, ureters and kidneys. Escherichia coli (E. coli), a type of bacteria normally found in the bowel, causes most uncomplicated UTIs.

The risk of developing a UTI may be higher if you:

• Are female, as the shorter urethra makes it easier for bacteria to reach the bladder
• Are sexually active
• Use certain contraceptives, particularly those containing spermicides
• Have gone through menopause
• Have kidney stones or another condition that affects the urinary tract
• Have difficulty emptying your bladder completely
• Have diabetes
• Have a weakened immune system
• Use a urinary catheter
• Have had UTIs before

Men can also develop UTIs. An enlarged prostate or another condition that affects the flow of urine can increase the risk.

Symptoms depend on which part of the urinary tract is affected.

A lower UTI, such as a bladder infection, may cause:

• Burning or pain when passing urine
• Needing to urinate more often than usual
• A sudden or urgent need to urinate
• Passing only small amounts of urine
• Pain or discomfort in the lower abdomen
• Cloudy urine
• Blood in the urine

A kidney infection may cause these symptoms as well as:

• Fever or chills
• Pain in the back or side, particularly below the ribs
• Nausea or vomiting
• Feeling weak or generally unwell

Seek prompt medical attention if you have fever or chills, pain in your back or side, vomiting or symptoms that are getting worse quickly. These may be signs that the infection has spread to the kidneys.

Your doctor will consider your symptoms, medical history and examination findings when assessing a suspected UTI. Similar symptoms can occur with other conditions, so treatment should not be based on symptoms alone in every situation.

Tests may include:

• Urine dipstick: A quick test that looks for substances such as nitrites and leucocytes, which can indicate infection or inflammation.
• Urinalysis: A laboratory examination of urine that may look for bacteria, white blood cells and red blood cells.
• Urine culture: A laboratory test that identifies bacteria in the urine and can help determine which antibiotics are likely to work. It may be particularly useful for recurrent or complicated infections, pregnancy or when symptoms do not improve with initial treatment.

Your doctor may recommend further tests if you have recurrent infections or there is concern about kidney stones, urinary blockage or another problem affecting the urinary tract.

Treatment depends on whether the infection affects the bladder or kidneys, your symptoms, medical history, kidney function, pregnancy status and other factors.

Antibiotics

Antibiotics are commonly used to treat bacterial UTIs when treatment is needed. The choice of antibiotic depends on the type and location of infection, local antibiotic resistance, previous urine culture results, allergies and your individual health needs.

Your doctor may prescribe medicines such as nitrofurantoin, trimethoprim, or fosfomycin based on your individual health and symptoms. Other antibiotics may be appropriate in certain circumstances. Medicines used for kidney infections can differ from those used for uncomplicated bladder infections.

Take the antibiotic exactly as prescribed. Do not use leftover antibiotics or take antibiotics prescribed for someone else. If you have been prescribed a course, follow the instructions provided by your healthcare professional.

Medicines for Pain and Discomfort

Paracetamol may help relieve pain or fever when it is suitable for you. Follow the recommended dose and check with your doctor or pharmacist if you are unsure whether it is appropriate.

Some urinary pain-relief medicines may temporarily reduce burning or discomfort but do not treat the infection itself. Speak with a pharmacist or doctor before using them.

Some people need medical assessment because they may require a different treatment or closer monitoring.

• Seek medical advice if you have UTI symptoms during pregnancy. UTIs during pregnancy need appropriate treatment because an untreated infection can spread to the kidneys and cause complications.
• Take a child with urinary symptoms to a healthcare professional for assessment. Treatment depends on the child's age, symptoms and medical history.
• If you are a man with UTI symptoms, see a doctor because further assessment may be needed to identify an underlying cause.
• Tell your doctor if you have kidney problems, as some medicines may require a dose adjustment or may not be suitable.
• Tell your doctor or pharmacist about any previous allergic reaction to antibiotics before starting treatment.
• If you have recurrent UTIs, your doctor may recommend a urine culture or further tests to identify the cause.
• If you use a urinary catheter and develop new urinary symptoms, seek medical advice because you may need specific treatment.
• Tell your doctor about all medicines and supplements you take to check for possible interactions.

Do not start, stop or change an antibiotic without medical advice. Unnecessary or incorrect use of antibiotics can contribute to antibiotic resistance.

Self-care can help relieve symptoms, but it cannot replace medical treatment when an antibiotic or other treatment is needed.

• Drink enough fluids throughout the day, unless you have been advised to restrict your fluid intake.
• Rest if you feel tired or unwell.
• Do not hold your urine for long periods.
• A warm water bottle or heat pad over the lower abdomen may help relieve discomfort.
• Avoid drinks that seem to worsen your bladder symptoms, such as coffee or alcohol.
• Take suitable pain relief as advised by your doctor or pharmacist.

Cranberry products may help reduce the risk of recurrent UTIs in some people, but they do not treat an active bacterial infection. They should not be used as a substitute for appropriate medical treatment.

If you have had UTIs more than once, a few everyday habits may help reduce the risk of another infection.

• Drink enough fluids throughout the day, unless you have been advised to restrict your fluid intake.
• Do not hold your urine for long periods when you need to pass it.
• Take your time when passing urine and avoid rushing.
• Wipe from front to back after using the toilet.
• Keep the genital area clean and avoid scented soaps, intimate washes and other products that may cause irritation.
• If you use spermicides and have recurrent UTIs, speak with your doctor or pharmacist about whether another contraceptive method may be suitable.
• If you notice that UTIs tend to occur after sex, passing urine soon afterwards may be worth trying, although evidence for its preventive effect is limited.
• If you continue to have recurrent UTIs, speak with your doctor about whether you need further assessment or preventive treatment.

For women who have recurrent UTIs after menopause, vaginal oestrogen may be considered. Your doctor can discuss whether it is suitable for you and explain other preventive options.

Seek medical advice if you have symptoms of a UTI, particularly if they are persistent or getting worse.

You should seek prompt medical attention if you have:

• Fever, chills or shivering
• Pain in your back or side, particularly below the ribs
• Nausea or vomiting
• Blood in your urine
• Symptoms that are worsening quickly
• Symptoms that are not improving after treatment
• UTI symptoms during pregnancy

Children with urinary symptoms, men with suspected UTIs and people with recurrent UTIs may also need medical assessment to identify the cause and determine the appropriate treatment.

UTIs commonly affect the bladder and can cause burning when passing urine, frequent urination, urgency and lower abdominal discomfort. When bacteria are responsible, antibiotics may be needed, but the choice of UTI medicine depends on the type of infection and your individual health needs.

Drink enough fluids, manage discomfort with suitable measures and take prescribed medicines as directed. If you develop fever, vomiting, pain in your back or side, or symptoms during pregnancy, seek medical attention promptly because these may indicate an infection that needs further assessment.