Antibiotics are an effective form of treatment for many urinary tract infections (UTIs). However, medical practitioners are increasingly hesitant to prescribe antibiotics with the continued rise and threat of antibiotic resistance. Antibiotic resistance is subject worthy of a blog in its own right, with bacteria that causeinfections slowly evolving to become resistant to usual forms of antibiotic treatment (typically referred to as ‘first-line antibiotics’), requiring the use of more expensive medicines in their place. Further, as the World Health Organisation point out, antibiotic resistance makes organ transplants, chemotherapy and surgeries like caesarean sections “much more dangerous”.
With this in mind, it is no wonder that doctors are reluctant to prescribe antibiotics for UTIs – particularly when the body can naturally overcome minor UTIs without medicinal intervention. That said, the National Institute for Health and Clinical Excellence (NICE) recommend that uncomplicated UTIs with symptoms that worsen, or don’t improve after 48 hours, should be reported to a GP, as antibiotic treatment may be required.
Bergamin and Kiosoglous (2017) investigated the notion of overcoming UTIs without medicinal intervention in women, 25-42% of uncomplicated UTIs resolved spontaneously, and in only 2% of instances, the untreated UTIs progressed to pyelonephritis (inflammation of the kidney). Knottnerus et al. (2013) reported similar findings, noting that a third of women with UTI symptoms delay antibiotic treatment when asked to do so by their GP, and 71% of these women “[reported] spontaneous symptom improvement after one week”.
Which UTIs won’t go away on their own?
Of course, not all UTIs were born equal. The Bergamin and Kiosoglous (2017) finding was based on ‘uncomplicated’ UTIs. What, therefore, constitutes a complicated UTI? And which UTIs require courses of antibiotics, or further, longer term treatment?
Complicated UTIs result from, or cause:
- Repeated infections. Repeated contraction of urinary tract infections may cause a doctor to recommend a long term programme of antibiotics, potentially lasting for six months or longer, requiring you to take a dose after sex, or for a series of days after symptoms show up.
- Kidney damage. Untreated UTIs can cause lasting damage to the kidneys, affecting their overall functioning, scarring them permanently, raising your blood pressure and many other issues. Fever and severe pain coinciding with a UTI are often indicators of an oncoming UTI complication, meaning that you may well be transferred to hospital if exhibiting these symptoms.
- Diabetes. People with diabetes have an much higher risk of complication when they contract a UTI, and therefore should act fast when they suspect they may have contracted a UTI. Diabetes sufferers can expect to be prescribed antibiotics or other forms of treatment to ward off complications.
- Pregnancy. UTIs are particularly common during pregnancy, and if left untreated, could cause problems for both mother and baby. The mother could develop high blood pressure or anemia, and the baby could end up with a low birth weight, or end up being delivered prematurely.
The National Institute for Health and Clinical Excellence (NICE) recommend that you have an uncomplicated UTI and symptoms are worsening, or at the very least not improving after 48 hours, you should see a GP as you may be developing a complicated UTI, which will require antibiotic treatment.
Men, too, should see a GP if they suspect they may have a UTI. UTIs in men usually result from blockages – be it from an enlarged prostate, urinary stone or problem with a catheter. Given the circumstances that cause them, these UTIs can be life-threatening, and as such, male UTIs should nearly always treated with antibiotics and other forms of long-term treatment.
How can I get rid of a UTI?
UTI remedies to avoid
First, a few home remedies that our own Dr Prudence Knight says simply will not work:
- Cranberry juice. Drinking cranberry juice is a common piece of advice associated with UTIs, although as Dr Knight notes, “plenty of studies have shown that the effect of cranberry juice on treating or preventing infections is actually very small”. She adds that although there is “a small amount of evidence” to suggest that cranberry juice can help, it certainly is not enough to be effective on its own.
- Baking soda. The theory behind this remedy recommendation, traditionally, was to change the acidity in the urinary tract and discourage bacteria from spreading. Once again, Dr Knight comments that “there is not actually any evidence that suggests that [baking soda] works” as a UTI home remedy.
- Apple cider vinegar. Recommended as a home remedy for the exact same reason baking soda often is, however the implications of using apple cider vinegar in this manner are much worse. Dr Knight notes that apple cider vinegar “can actually make a UTI worse” if used as treatment, rather than a form of prevention. Dr Knight expands on this point: “...acidic vinegar is the last thing you want coming into contact with the irritated lining of your urinary tract” when a UTI has taken hold.
UTI remedies to use
Dr Knight concludes that the following will ease your symptoms and speed up recovery, however:
- Over the counter pain medication and plenty of rest
- Drinking ample fluids and not delaying urination to help efficiently flush out bacteria
- Avoiding bladder aggravating drinks like coffee, alcohol and citrus-based drinks
- Resting a hot water bottle on your stomach or back, whichever side of your body is in more pain
- Avoiding having sex until you have fully recovered