Urinary Tract Infections in Teens and Adults - Treatment Overview

Treatment Overview

Antibiotics can treat most urinary tract infections (UTIs) successfully. The goals of treatment for UTIs are to relieve symptoms, eliminate the infection and prevent recurrence, and prevent unlikely but serious complications such as kidney damage and sepsis. In pregnant women, treatment protects the woman and the fetus.

Initial treatment

Treatment for uncomplicated bladder infections in women usually is 3 days of antibiotics. Home treatment includes drinking a lot of water and fluids and urinating frequently, emptying your bladder each time. Additional testing is not necessary if your symptoms improve.

Oral antibiotics usually can treat kidney infections (pyelonephritis), although you may need brief hospitalization and a short course of intravenous (IV) antibiotics if you are too ill or nauseated to take medicine by mouth (oral medication). Kidney infections tend to make people more severely ill than bladder infections. After you are feeling better, you may take oral antibiotics, typically for about 2 weeks. Your doctor probably will test your urine for bacteria after treatment, to be certain you no longer have an infection.

Your antibiotic treatment may take longer and you may require further testing before and after treatment if you:

• Are pregnant.
• Are older than 65.
• Have diabetes or an impaired immune system.
• Are a man. UTIs in men typically require 1 to 2 weeks of antibiotics. Additional testing and treatment for prostate problems (such as prostatitis) or sexually transmitted diseases (such as chlamydia or gonorrhea) may be necessary.

If you have a severe kidney infection, or if a bladder or kidney infection is complicated by other factors, you may need hospitalization.

Treatment if the condition gets worse or recurs

If your urinary tract infection (UTI) does not improve after treatment with antibiotics, you will need further evaluation and additional antibiotic treatment.

If the infection spreads and affects your kidney function or causes widespread infection (sepsis), you will need hospital care. These complications are not common, and they rarely occur in people who are otherwise healthy. People are at higher risk if they have an impaired immune system, diabetes, untreated urinary tract obstruction, and/or other conditions that affect the kidneys or bladder.

A new infection, rather than a relapse of the same infection, usually is the cause of a UTI that keeps coming back (recurs).

• Women with recurrent bladder infections may take antibiotics for 6 months, followed by preventive antibiotic therapy.¹
• Recurrent UTIs in men are usually a sign of prostate infection (prostatitis). Chronic prostatitis can be difficult to treat and may take up to 6 weeks of antibiotic therapy. For more information, see the topic Prostatitis. Follow-up checkups are usually necessary in men who have UTIs and are always necessary if the infection recurs.

What To Think About

Your doctor may base treatment decisions for a bladder infection on your symptoms and urinalysis results, without doing a urine culture. If treatment clears up the symptoms, it confirms the diagnosis of a simple, uncomplicated UTI. If the symptoms do not clear up, you will need further testing to look for:

• A kidney infection.
• Structural problems with the kidneys that increase the risk of infection.
• Infection with an uncommon bacteria.
• An impaired immune system.
• A cause for the symptoms that is not an infection.

If group B streptococcal infection causes a UTI in a pregnant woman, she will receive antibiotic treatment during labor so that she does not pass the infection to her baby.²

Many forms of bacteria have become resistant to common antibiotics designed to destroy them. These are called antibiotic-resistant bacteria. Antibiotic resistance among bacteria that cause UTIs has increased steadily in recent decades.

You and your doctor may have to try different antibiotics, and different combinations of antibiotics, to find the right medication that will kill the bacteria causing the UTI. But in most cases, a urine culture and antibiotic sensitivity test will help find the right antibiotic to use.