Urinary Tract Infection (UTI)

Diagnosis

To diagnose a urinary tract infection (UTI), your healthcare provider will evaluate your symptoms and may recommend several tests to confirm the infection and identify its cause. Understanding the type and severity of infection helps guide the best treatment approach.

Common diagnostic tests and procedures include:

• Analyzing a urine sample: You may be asked to provide a midstream urine sample after cleaning your genital area. The lab checks for white blood cells, red blood cells, or bacteria that indicate infection.

• Growing urinary tract bacteria in a lab: A urine culture is done to identify the bacteria causing the infection and determine which antibiotics will be most effective.

• Creating images of the urinary tract: Recurrent UTIs may be linked to structural abnormalities. Imaging tests such as ultrasound, CT scan, or MRI can help identify any blockages or abnormalities in the urinary system.

• Using a scope to see inside the bladder: A procedure called cystoscopy uses a thin tube with a lens (cystoscope) to view the urethra and bladder. This test is often done for people who experience frequent or chronic UTIs.

These tests help ensure accurate diagnosis and effective treatment planning for both men and women.

Treatment

Antibiotics are the primary treatment for urinary tract infections. The choice of medicine and duration of treatment depend on the type of bacteria, the severity of infection, and your overall health.

Simple Infections

For uncomplicated UTIs, commonly prescribed antibiotics include:

• Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS)

• Fosfomycin

• Nitrofurantoin (Macrodantin, Macrobid, Furadantin)

• Cephalexin

• Ceftriaxone

Fluoroquinolones, such as ciprofloxacin and levofloxacin, are usually not used for simple infections due to higher risk of side effects. However, they may be prescribed for complicated UTIs or kidney infections when no other options are suitable.

Symptoms usually start to improve within a few days of starting antibiotics, though full healing may take longer. Always complete the prescribed course, even if symptoms improve early. In mild cases, a short course of antibiotics lasting one to three days may be enough, depending on your medical history and doctor’s recommendation.

Pain-relief medicines may also be prescribed temporarily to ease discomfort when urinating.

Preventing Repeat Infections

After treatment, preventive strategies can help reduce the risk of future UTIs:

• Drink plenty of fluids: Staying hydrated helps flush bacteria from the urinary tract. Aim for at least 1.5 liters (about 50 ounces) of fluids daily, unless advised otherwise.

• Try topical vaginal estrogen therapy: For women in perimenopause or menopause, low-dose vaginal estrogen may help prevent repeat infections if appropriate for their health.

• Manage constipation: Eat fiber-rich foods such as fruits, vegetables, beans, and whole grains, and stay active to promote healthy bowel movements.

• Try cranberry products: Some people find cranberry juice or supplements helpful in preventing UTIs. While research is mixed, moderate consumption is generally safe for most people. Avoid cranberry juice if you take blood thinners like warfarin.

• Avoid irritating feminine products: Deodorant sprays, douches, and powders can irritate the urethra and increase infection risk.

• Change your birth control method: Diaphragms, non-lubricated condoms, or spermicidal condoms can promote bacterial growth. Ask your doctor about safer alternatives.

Your healthcare provider may also suggest supplements or non-antibiotic medicines to further reduce the risk of recurrence.

Frequent Infections Despite Preventive Efforts

If UTIs continue to return despite preventive measures, your doctor may recommend specialized antibiotic use strategies, such as:

• Self-start therapy: You may be prescribed antibiotics to keep at home and start treatment when symptoms appear, while maintaining communication with your doctor.

• Post-intercourse antibiotics: A single dose taken after sexual activity if UTIs are triggered by sex.

• Long-term low-dose antibiotics: Continuous low-dose antibiotics taken for six months or longer under medical supervision.

While antibiotics are effective, they can have side effects such as rash, nausea, or diarrhea. Overuse can also lead to antibiotic resistance, making bacteria harder to treat. Therefore, preventive strategies that do not involve antibiotics are preferred when possible.

Severe Infections

In cases of severe or complicated UTIs, hospitalization and intravenous (IV) antibiotics may be necessary. This approach ensures that strong medications can quickly reach the bloodstream to eliminate infection and prevent complications.

Managing urinary tract infections promptly and following preventive care recommendations can significantly reduce recurrence and improve urinary health.