By Yolanda Smith, BPharm
Antibiotics are the first-line treatment of choice, as bacteria are responsible for causing urinary tract infections (UTIs). In some cases, symptomatic relief is also used to provide immediate relief from the burning and urgency associated with a urinary tract infection.
Uncomplicated UTIs include most women that display symptoms of a bladder infection. Approximately half of all cases will resolve of their own accord even without treatment within a few days or weeks.
However, a short course of antibiotics (3-5 days) is almost uniformly sufficient in treating the causative bacteria, eliminating symptoms and preventing recurrence of the infection.
Oral antibiotics that may be used to treat uncomplicated UTIs include trimethoprim, sulfamethoxazole, nitrofurantoin, cephalosporins or amoxicillin/clavulanic acid. Trimethoprim is a convenient medication option as it has an easy once-daily dosing for 3 days, which increases compliance. From the initiation of antibiotic therapy, symptoms should improve within 1-2 days.
Complicated infections include all men with a urinary tract infection, as well when there is kidney involvement. This is a more severe type of infection and typically requires more aggressive treatment and comprehensive follow-up to avoid recurrence on infection.
The same classes of antibiotics as in uncomplicated UTI are used to treat complicated infections, but the dosing often differs slightly. Intravenous administration is often recommended initially for a timely response and the duration of treatment, continued orally, is significantly longer for 10-14 days.
Antibiotic resistance is a valid concern for many patients, especially those that suffer from recurrent infections. For this reason, a urine sample is often taken to test the sensitivity of the bacteria to certain treatments to help choose a targeted treatment and prevent future bacterial resistance.
Catheter Induced Infections
The use of a catheter greatly increases the risk of a UTI and should only be used when and for no longer than necessary. This risk can be reduced with intermittent use of a catheter, rather than for long continuous periods. Additionally, maintaining appropriate hygiene standards is essential, in addition to keeping fluid intake high.
If an infection develops when a catheter is being used, it should be removed or changed immediately. As there is a wide range of possible causative bacteria, empirical antibiotic therapy should be initiated immediately. A urine sample can then be used to identify actual causative bacteria and treatment with a narrower spectrum antibiotic with specificity for the bacteria may be used.
In addition to medical management, there are some simple changes to diet and lifestyle that can help in the treatment of urinary tract infection.
Maintaining high fluid intake is essential to keep the urinary tract working and pushing the urine through the body. This is very effective and flushing the bacteria out of the bladder and clearing the infection, which results in an improvement of symptoms. Many people tend to drink less when they have a urinary tract infection because it is painful to urinate, but it is important that they understand drinking promotes a healthier urinary tract.
Drinking cranberry juice has also been suggested as a possible treatment for UTI, particularly for the management of symptoms. However, the scientific evidence to support this claim is lacking and, based on the available data, cranberry juice should not be recommended for the treatment of urinary tract infection. However, it is unlikely to result in significant side effects.
Last Updated: Jun 14, 2015