How to Get Rid of a UTI - Integris

27 December 2022

Urinary tract infections are common among women, so common that many think they can treat them at home and go about their day. But are at-home treatments enough or do antibiotics provide the best remedy? This blog will explore why it's important to treat UTIs early, which bacteria causes UTIs and which antibiotics may be prescribed to treat an infection.

UTI basics

Urinary tract infection is an umbrella term to describe any type of bacterial infection that impacts the urinary tract – urethra, ureters, kidneys and bladder. UTIs are one of the most common bacterial infections you can get, affecting both children and adults. 

Gender is the most common risk factor in developing UTIs. Most UTIs occur in women due to the close proximity of the urethra to the anus, which allows bacteria to more easily enter the urinary tract. In fact, women are 33 times more likely to develop a UTI. Children are also prone to UTIs, especially children under the age of 5 and uncircumcised boys.
UTIs can cause you to urinate more or produce pain and a burning sensation when using the bathroom. Additional symptoms include fever, pelvic pain and cloudy or bloody urine. 

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

Urethritis: Urethritis occurs when bacteria is contained to the urethra.

Cystitis: Also known as a bladder infection, cystitis occurs when bacteria moves from the urethra into the bladder and causes an infection. It is the most common type of UTI.

Pyelonephritis: Also known as a kidney infection, pyelonephritis occurs when bacteria moves through your urine from the urethra to the bladder and into the kidney to cause an infection. Kidney infections can be severe and require more immediate medical attention, as kidney damage can occur without treatment.

Types of bacteria that cause UTIs

Escherichia coli (E. coli) is responsible for as many as 90 percent of UTIs, although there are many types of bacteria that can cause infections in your urinary tract.

These types of bacteria fall under two categories: gram-positive or gram-negative. This distinction has to do with how the bacteria is structured. Some bacteria contain an outer cell membrane wall called peptidoglycan that is made of sugars and amino acids. Gram-negative bacteria contain this outer membrane while gram-positive bacteria don't. Why does this matter? The outer membrane can make it more difficult to treat due to the extra layer.

Gram-negative bacteria

• Escherichia coli (E. coli): As many as 90 percent of UTIs originate from E. coli, primarily due to the close proximity of the anus to the urethra where E. coli can enter the urinary tract.
• Klebsiella pneumonia: Klebsiella is less common and usually only appears in infants who have issues voiding urine and adults who have been hospitalized. 
• Proteus mirabilis: This type of bacteria is often the third most common pathogen to cause UTIs behind E. coli and staphylococcus saprophyticus. It typically affects patients with long-term catheter use.
• Pseudomonas aeruginosa: This type of bacteria is rare but hard to treat. It typically affects patients with long-term catheter use.

Gram-positive bacteria

• Staphylococcus saprophyticus: This bacteria accounts for anywhere between 10 to 20 percent of UTIs. It is most common in young, sexually active women. While common, it is susceptible to many antibiotics, including penicillin. 
• Staphylococcus aureus: Compared to Staph S, this type of bacteria is more rare and usually only affects pregnant women and people who use catheters. 
• Group B Streptococcus (GBS): This type of bacteria is most likely to cause UTIs in older adults (especially those who are immunocompromised due to cancer and other chronic diseases) and pregnant women. Pregnant women are usually tested for GBS in their third trimester, usually between weeks 35 and 37. 
• Aerococcus: This is another rare type of bacteria that can cause UTIs in older adults, predominantly women.
• Enterococcus: This type of bacteria can cause UTIs in people who use catheters and people with diabetes who can't empty their bladder well. It is also one of the leading causes of hospital-associated UTIs. Many strains of enterococci have become resistant to antibiotics. 

How to get rid of a UTI

While some symptomatic UTIs may remain mild enough to resolve on their own, antibiotics usually remain the best course of treatment for these types of infections. More severe cases may require hospitalization to administer IV antibiotics. Examples include kidney infections, UTIs in infants or UTIs in children that cause dehydration.

In addition to antibiotics, your primary care physician or urologist may prescribe an anticholinergic to help with any associated bladder pain. Some women experience bladder spasms with a UTI, and anticholinergics are drugs that block the action of acetylcholine, a neurotransmitter responsible for involuntary muscle movements. 

A pain reliever may also accompany an antibiotic to help relieve any discomfort or burning sensations associated with the UTI. Another option is to take phenazopyridine (Uristat) to numb your bladder so it is easier to urinate.

Each UTI is different, though, so contact your doctor to receive guidance on how to proceed with treatment.

Can UTIs be treated at home?

Again, antibiotics are the safest, best course of treatment to contain a symptomatic UTI and reduce the risk of causing long-term damage. 

Still, some people may choose to treat their UTI at home with over-the-counter remedies such as cranberry juice or supplements. There is some literature that determined cranberry juice can help prevent UTIs, although another study found cranberry juice doesn't reduce the risk of UTIs. Regardless of prevention, cranberry juice won't help active cases of UTIs, which is why it's important to contact your doctor and receive an antibiotic.

You may also have heard about increasing your fluid intake to help flush the bacteria from your body. While staying hydrated is beneficial to treat any type of infection, antibiotics are the only way to contain and eliminate bacteria.

Diagnosing a UTI

Call your doctor if you experience pain while urinating, cloudy or bloody urine, a fever, an intense urge to urinate or pain in your abdomen. Usually, two of these symptoms indicate a UTI. 

Before you receive antibiotics, your doctor will usually – but not always – perform two tests to learn more about the bacteria in your urinary tract. A urinalysis can confirm a UTI, and a urine culture shows which bacteria caused the infection.

Urinalysis

First, a urinalysis analyzers your urine for abnormalities that can signify a UTI. Using a urine sample, a laboratory test can tell you the following:

• Red blood cell count
• White blood cell count
• If bacteria is present
• If the urine is acidic or basic
• Urine concentration

Urine culture

Once your doctor confirms the UTI, they will send your urine sample off to the lab to grow in an incubator for 24 to 48 hours. In the lab, they add substances that help bacteria multiply faster to determine the specific type. 

A urine culture is important for people who have recurrent UTIs or aggressive infections that require a specific antibiotic, rather than a broad spectrum treatment.

Since the culture takes several days, your doctor may wait for the results before prescribing a medication. In more severe cases, though, you can receive an antibiotic immediately to help control the infection.

UTI treatment using antibiotics

The benefits outweigh the risks when it comes to antibiotics. Untreated UTIs – even if you think they're minor – can progress into something more severe, such as a kidney infection.

Your doctor may refer to your UTI as complicated or uncomplicated. Uncomplicated simply means you have a normal, unobstructed urinary tract and your symptoms are contained to the lower urinary tract (bladder and urethra). By contrast, a complicated UTI means your UTI doesn't respond well to traditional treatments, whether because you have recurrent UTIs or some anatomical abnormality, such as a damaged kidney or vesicoureteral reflux (VUR) in which urine backs up into the kidney.

When treating UTIs with antibiotics, you should be familiar with two terms: susceptible and resistant. In short, susceptible is a positive word to hear from your doctor, while resistant comes with a negative connotation. 

Once your urine sample is collected, a urine culture will grow the bacteria to determine how to treat it. Certain bacteria are susceptible to antibiotics, meaning the antibiotics can treat that type of bacteria. Unfortunately, certain bacteria are also resistant to some antibiotics, meaning specific antibiotics won't work in controlling that type of bacteria.

An oral antibiotic may be prescribed for as few as one to three days or as long as a week or two.

Antibiotics to treat most uncomplicated UTIs

If this is your first UTI and you have no history or additional complications with the urinary tract, your doctor will likely prescribe one of the following medications. For example, Bactrim and Macrobid are two of the most common drugs to treat simple bladder infections. 

• Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS): This drug inhibits bacteria from making proteins and DNA needed to survive.
• Nitrofurantoin (Macrodantin, Macrobid, Furadantin): This drug inhibits bacteria from making proteins and DNA needed to survive. It is one of the most common drugs prescribed to treat UTIs.
• Fosfomycin (Monurol): This single-dose drug both kills the bacteria and prevents it from adhering to the urinary tract lining.
• Cephalexin (Keflex): This drug works by destroying a bacterium's cell wall. It is sometimes used as a treatment for recurrent UTIs.

Some medications, such as a group called cephalosporins that includes cephalexin (Keflex), cefuroxime (Ceftin) and cefixime (Suprax), may be helpful for short-term treatments, but your body can become resistant to them over time. Your doctor may also prescribe amoxicillin/potassium clavulanate (Augmentin) or doxycycline (Monodox).

More severe, complicated UTIs may require treatment with antibiotics called fluoroquinolones. Ciprofloxacin (Cipro) and levofloxacin (Levaquin) are the two most common types. The side effects of these drugs can be harmful, though, so they're only prescribed in certain circumstances.

Recurrent UTIs

A single UTI usually responds well to time or a short dose of antibiotics. Some people, including women and young children, may experience recurrent UTIs that become harder to treat.

Sexually active women are prone to UTIs due to bacteria that can be pushed into the urethra during intercourse. They may also occur when wiping back to front after a bowel movement – bacteria from stool can transfer more easily this way. Using spermicides and certain contraceptives can promote bacterial growth that leads to UTIs.

As you age, women in menopause have lower levels of a good type of bacteria called lactobacilli. The bladder also contracts less strongly than it once did, making it more difficult to empty it completely.

Some children are born with birth defects that impact how urine flows. For example, vesicoureteral reflux occurs when urine flows back into the ureters (and sometimes the kidney). When bacteria enters the urine, it can back up into the kidney and cause pyelonephritis. Some children also have a dilated kidney(s) called hydronephrosis. Usually, this occurs when urine backs up into the kidney due to reflux or a blockage and causes swelling.

In the case of a chronic medical condition, such as vesicoureteral reflux, a doctor may prescribe continuous antibiotic prophylaxis to treat UTIs. An antibiotic is taken every day to keep bacteria at normal levels and prevent UTIs.

However, bacteria can easily adapt and evolve over time and become resistant to antibiotics, making it harder to fight recurrent infections. 

Whether you find yourself experiencing symptoms from your first UTI or a recurrent UTI, contact your doctor and discuss what steps to take next. They can prescribe an antibiotic, if necessary, or refer you to a urologist for further evaluation.

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