What Is A Urinary Tract Infection (UTI)

If you have ever experienced painful burning urination and the frequent need to go the bathroom, you have probably experienced a urinary tract infection (UTI). But you may be surprised to know that UTIs are the second most common type of infection in the body, accounting for about 8.1 million visits to health care providers each year. Sometimes a UTI can be self-limiting, meaning that your body can fight the infection without antibiotics; however, most uncomplicated UTI cases can be treated quickly with a short course of oral antibiotics.

Common Antibiotics Associated With the Treatment of UTIs
Where does a UTI occur? A UTI infection can happen anywhere along your urinary tract, which includes the kidneys (the organ that filters the blood to make urine), the ureters (the tubes that take urine from each kidney to the bladder), the bladder (stores urine), or the urethra (the tube that empties urine from the bladder to the outside). A lower urinary tract infection occurs when bacteria gets into the urethra and is deposited up into the bladder (cystitis). Infections that get past the bladder and up into the kidneys are called pyelonephritis . An infection of the tube that empties urine from the bladder to the outside is called urethritis.

The symptoms of a UTI may include:

Pain or burning upon urination
A frequent or urgent need to urinate
Blood in the urine or a cloudy or pink-stained urine
Pain, cramping in the lower stomach
Upper UTIs which include the kidney may also have symptoms of fever, back pain, and nausea or vomiting.

Use the Symptom Checker to Make an Informed Decision About Your Health
Urinary tract infections occur more frequently in women than in men because a woman’s urethra is shorter and closer to the anus than in men, allowing easier entry of bacteria into the urethra.

Women are also more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI. For women, the risk of having a UTI over her lifetime exceeds 50 percent. UTIs in men can be serious when they occur, so a quick diagnosis is important.

UTIs in Women
UTIs in Men

Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Catheters decrease the normal ability to clear bacteria from the urinary tract. The bacteria travel can become trapped in the catheter, multiply and infect the bladder.

Who Is At Risk For A UTI?
Factors that may increase your chances of developing a UTI include:

Diabetes
Advanced age and difficulties with activities of daily living
Inability to completely empty the bladder
Having a urinary catheter
Bowel/fecal incontinence
Enlarged prostate, narrowed urethra, or anything that blocks the flow of urine
Kidney stones or ureteral reflux
Reduced mobility (e.g. after surgery or prolonged bedrest)
Pregnancy
Surgery or other procedure involving the urinary tract
Having frequent sex or sex with a new partner
Previous UTI in the last 12 months
Using spermicide for birth control
Uncircumcised men or men who have anal sex
Possible genetic predisposition

How Is a UTI Diagnosed?
If you suspect you have a UTI, you probably want to get a diagnosis as soon as possible. Not only is it uncomfortable to have a UTI, you may need antibiotics. Your doctor can normally diagnose a bladder infection (cystitis) based on your symptoms and a simple urine test that looks for white blood cells.

If your doctor suspects a kidney infection, s/he may order a urine culture which grows the bacteria in the laboratory, usually over a 48 hour period. Antibiotic treatment can be more specifically tailored to your type of UTI in this case.

Learn More About Urine Culture
In some cases, your doctor may order images of your urinary tract with either an ultrasound or a computerized tomography (CT) scan. These images can detect abnormalities in the urinary tract.

Learn More About CT Scans
What Medication Treatments Are Available for UTI?
Antibiotics are typically used to treat UTIs, but patients may need different antibiotics depending upon the type of bacterium present in the urine. Different treatments may be recommended in different areas of the country based on regional patterns of drug resistance. Symptoms like burning urination will usually clear up in within one day after starting treatment. Be sure to finish your entire course of medication.

Antibiotics that may be recommended for UTI treatment include:

Sulfamethoxazole-trimethoprim (Bactrim, Septra DS, others)
Amoxicillin
Nitrofurantoin (Macrobid, others)
Fosfomycin (Monurol)
Ciprofloxacin (Cipro)
Levofloxacin (Levaquin)

Latest FDA antibiotic approvals for UTIs:

Avycaz
Zerbaxa
Doribax
Proquin XR

More treatment options….

Your provider may prescribe an additional product to numb your bladder and urethra called phenazopyridine (Pyridium) that will ease the burning pain during urination. A similar product called Uristat can also be bought without a prescription at the pharmacy. Take phenazopyridine for only 48 hours, and be aware it may cause your urine to turn a brown, orange or red color which may stain fabrics.

If you are pregnant, have a severe UTI, high fever, or cannot keep fluids and food down, your doctor may admit you to the hospital so you can have treatment with intravenous (through the vein) antibiotics. You may return home and continue with oral antibiotics when your infection starts to improve.

What If I Have Frequent, Recurring UTIs?
If you have recurrent UTIs, your doctor may look at your urinary tract with an ultrasound, a computerized tomography (CT) scan or an intravenous pyelogram (IVP) that uses an X-ray with injected contrast dye. Your doctor may also perform a cystoscopy to look inside the urethra and bladder. A cytoscope is a long, thin tube that is inserted in the urethra and passed through to the bladder. Kidney stones can be detected with this method.

For recurrent UTIs, there are several treatment options:

A shorter course (3 days) of antibiotics at the first sign of UTI symptoms; a prescription may be given to you to keep at home.
A longer course of antibiotic therapy.
Take a single dose of an antibiotic after sexual intercourse.
Vaginal estrogen treatment in postmenopausal women with vaginal dryness.

Can I Prevent A Urinary Tract Infection?
There are several measures that can be taken to prevent an initial or recurrent urinary tract infection, as recommended by the National Institute of Health:

Wipe from front to back after using the bathroom.
Use sanitary pads instead of tampons, tampons may make UTI infections more likely. Change your pad each time you use the bathroom.
Do not douche or use feminine hygiene sprays or powders.
Take showers instead of baths, and avoid bath oils and bubble bath.
Clean your genital and anal areas before and after sexual activity.
Urinate before and after sexual activity.
Avoid tight-fitting pants. Wear cotton-cloth underwear and pantyhose, and change both at least once a day.
Drink plenty of fluids — 2 to 4 quarts each day.
Do not drink fluids that irritate the bladder, such as alcohol and caffeine.
What Alternative Treatments are Available for UTIs

The following products are considered to be alternative treatments, herbals or natural remedies for a urinary tract infection. Their efficacy may not have been scientifically tested to the same degree as the drugs listed above. However there may be historical, cultural or anecdotal evidence linking their use to the treatment of urinary tract infection. Side effects and drug interactions may still occur with alternative treatments. Always check with your doctor or pharmacist before using an alternative treatment for any condition.