About half of all women will have a urinary tract infection (UTI) at some point in their lifetime, and most will be treated with antibiotics to eliminate the infection.
While these medications have long been the standard treatment for a UTI, concerns about unnecessary antibiotic use and the growing problem of antibiotic resistance have raised questions about whether the drugs are always needed. Without antibiotic treatment, will a UTI go away on its own?
First, it helps to understand what a UTI is. UTI is classified into two broad categories, uncomplicated, also known as cystitis, and complicated, such as pyelonephritis, catheter-associated, UTI during pregnancy and UTI in setting of kidney stone.
When bacteria invade the urethra (the opening to the urinary tract) and track upwards to the bladder, it causes infection and inflammation in a normally sterile environment. In most cases, UTIs are caused by E. coli bacteria normally found in the bowels that venture out to an area in our body where it is not used to being.
A mild UTI causes symptoms, including painful urination, constantly feeling the need to urinate and cramping pain in the lower abdomen. In the elderly population, a mild UTI can even cause confusion. Symptoms from a complicated UTI include fever, lower back pain, blood in urine, and even pus in urine.
“Not only are bladder infections painful, but also can be dangerous if left untreated. Bacteria from a bladder infection can easily travel to the kidneys and cause serious problems, including infection of the kidneys, known as pyelonephritis with or without abscess; a blood stream infection or bacteremia; cardiovascular collapse, also known as shock; and potential kidney failure,” says Varinthrej Pitis, MD, an internal medicine physician at Scripps Clinic Carmel Valley. “Early use of antibiotics can eliminate the infection and prevent complications.”
While some UTIs may go away without antibiotic treatment, Dr. Pitis cautions against foregoing antibiotics.
“While it’s possible for the body to clear a mild infection on its own in some cases, it can be very risky not to treat a confirmed UTI with antibiotics,” says Dr. Pitis.
A provider can test for a UTI with a urine sample. Urinalysis conducted at the office immediately identifies elevated levels of certain substances in the urine that can indicate a UTI. If necessary, your provider may also send the sample to a lab to confirm the presence of bacteria before an antibiotic is prescribed.
Collecting a urine sample for testing isn’t always necessary. Current guidelines are that if a woman has symptoms of a UTI and no fever or underlying problems, she has cystitis and a provider can proceed with a treatment of microbial (anti-bacterial) drugs and/or analgesics (pain relievers). However, if you do not respond appropriately to the initial course of antibiotics or you have prior numerous recurrent infections and drug-resistant organism is a concern, your urine will be sent for culture and antibiotic susceptibility testing.
“Your provider will determine if and when you should start a course of antibiotics,” says Dr. Pitis. Dr. Pitis adds that at-home treatments for UTIs, such as cranberry juice and vitamin C, have not proven effective in eliminating infection. “Cranberry juice and Vitamin C do alter the pH in your urine and make it slightly more difficult for E coli to adhere on the urinary tract wall, which theoretically should prevent UTI. However, once you already have UTI, these home remedies have not been proven to treat or eradicate the infection.”
UTI symptoms can include one or more of the following:
- Pain or burning when urinating
- Feeling like you still need to urinate even after you have just done so (urgency)
- Feeling like you need to urinate unusually often, even if your body does not pass urine (frequency)
- Pressure and cramping in the lower belly
- Urine that has a strong smell
- Urine that looks cloudy or reddish
- Feeling weak or shaky
- Alter mental status, usually in elderly and young kids
Call your doctor right away if you have:
- Blood in your urine
- Lower back pain
- Poor appetite
- Decreased urine production
Some women are more genetically prone to developing UTIs than others, and sexual intercourse can raise the risk of bacteria entering the urethra. Women who get frequent UTIs after sex may help prevent them by making sure to urinate after intercourse or taking post-coital, low-dose antibiotics as a preventive measure.
“If you think you might have a UTI, you should see a provider, either in person or virtually,” says Dr. Pitis. “Together, you can decide the best course of treatment to eliminate the infection and prevent complications.”