Antibiotics For Urinary Tract Infections In Older People
Antibiotics are medicines that can kill bacteria. Health care providers often use antibiotics to treat urinary tract infections .
The main symptom of a UTI is a burning feeling when you urinate.
However, many older people get UTI treatment even though they do not have these symptoms. This can do more harm than good. Heres why:
Antibiotics usually dont help when there are no UTI symptoms.
Older people often have some bacteria in their urine. This does not mean they have a UTI. But health care providers may find the bacteria in a routine test and give antibiotics anyway.
The antibiotic does not help these patients.
- It does not prevent UTIs.
- It does not help bladder control.
- It does not help memory problems or balance.
Most older people should not be tested or treated for a UTI unless they have UTI symptoms. And if you do have a UTI and get treated, you usually dont need another test to find out if you are cured. You should also not be tested just in case there is a UTI.
You should only get tested or treated if UTI symptoms come back.
Antibiotics have side effects.
Antibiotics can have side effects, such as fever, rash, diarrhea, nausea, vomiting, headache, tendon ruptures, and nerve damage.
Antibiotics can cause future problems.
Antibiotics can kill friendly germs in the body. This can lead to vaginal yeast infections. It can also lead to other infections, severe diarrhea, hospitalization, and even death.
When should older people take antibiotics for a UTI?
When To Get Medical Advice
It’s a good idea to see your GP if you think you might have a UTI, particularly if:
- you have symptoms of an upper UTI
- the symptoms are severe or getting worse
- the symptoms haven’t started to improve after a few days
- you get UTIs frequently
Your GP can rule out other possible causes of your symptoms by testing a sample of your urine and can prescribe antibiotics if you do have an infection.
Antibiotics are usually recommended because untreated UTIs can potentially cause serious problems if they’re allowed to spread.
Does Cranberry Juice Prevent A Urinary Tract Infection
Many people say that cranberry juice can help treat, or even prevent, a UTI. Researchers are currently looking into the topic, but havent found a definitive answer yet. Healthcare providers recommend drinking lots of fluids if you have, or have a history of getting, a UTI. Adding a glass of unsweetened cranberry juice to your diet isnt a proven way to prevent a UTI, but it typically wont hurt you either.
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Treatment Strategies For Recurrent Utis
Recurrent urinary tract infections, defined as three or more UTIs within 12 months, or two or more occurrences within six months, is very common among women these but arent treated exactly the same as standalone UTIs. One of the reasons: Continued intermittent courses of antibiotics are associated with allergic reactions, organ toxicities, future infection with resistant organisms, and more.
Because of this, its strongly recommended that you receive both a urinalysis and urine culture from your healthcare provider prior to initiating treatment. Once the results are in, the American Urological Association suggests that healthcare professionals do the following:
- Use first-line treatments. Nitrofurantoin, TMP-SMX, and fosfomycin are the initial go-tos. However, specific drug recommendations should be dependent on the local antibiogram. An antibiogram is a periodic summary of antimicrobial susceptibilities that helps track drug resistance trends.
- Repeat testing. If UTI symptoms persist after antimicrobial therapy, clinicians should repeat the urinalysis, urine culture, and antibiotic susceptibility testing to help guide further management.
- Try vaginal estrogen. For peri- and post-menopausal women with recurrent UTIs, vaginal estrogen therapy is recommended to reduce risk of future UTIs.
Are There Any Over
Over-the-counter antibiotics for a UTI are not available. You should see your doctor to have your symptoms evaluated.
Your provider may recommend an OTC product called Uristat to numb your bladder and urethra to ease the burning pain during urination. Uristat can be bought without a prescription at the pharmacy. A similar phenazopyridine product called Pyridium is also available.
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 or contact lenses. It may be best to not wear contact lenses while being treated with phenazopyridine.
Phenazopyridine is not an antibiotic and will not cure a UTI.
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Can A Uti Go Away On Its Own
While most patients with a UTI will be prescribed antibiotics, the truth is, uncomplicated urinary tract infections are often self-limiting, meaning they can potentially run their course sans antibiotic treatment, noted a 2018 report in PLoS Medicine.
In fact, that same report found that more than one-half of the women studied experienced a UTI resolution without the use antibiotics. However, since kidney infections occurred in 7 out of 181 women using ibuprofen, the researchers concluded that, at this time, they cannot recommend ibuprofen alone as initial treatment to women with uncomplicated UTIs.
A better idea, for now: Simply wait until a positive urine culture comes back before treating with antibiotics.
Uti Tests And Diagnosis
If you suspect that you have a urinary tract infection, go to the doctor. You’ll give a urine sample to test for UTI-causing bacteria.
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If you get frequent UTIs and your doctor suspects a problem in your urinary tract, they might take a closer look with an ultrasound, a CT scan, or an MRI scan. They might also use a long, flexible tube called a cystoscope to look inside your urethra and bladder.
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How Are Urinary Tract Infections Diagnosed
Your doctor will use the following tests to diagnose a urinary tract infection:
- Urinalysis: This test will examine the urine for red blood cells, white blood cells and bacteria. The number of white and red blood cells found in your urine can actually indicate an infection.
- Urine culture: A urine culture is used to determine the type of bacteria in your urine. This is an important test because it helps determine the appropriate treatment.
If your infection does not respond to treatment or if you keep getting infections over and over again, your doctor may use the following tests to examine your urinary tract for disease or injury:
- Ultrasound: In this test, sound waves create an image of the internal organs. This test is done on top of your skin, is painless and doesnt typically need any preparation.
- Cystoscopy: This test uses a special instrument fitted with a lens and a light source to see inside the bladder from the urethra.
- CT scan: Another imaging test, a CT scan is a type of X-ray that takes cross sections of the body . This test is much more precise than typical X-rays.
Check If It’s A Urinary Tract Infection
Symptoms of a UTI may include:
- pain or a burning sensation when peeing
- needing to pee more often than usual during the night
- pee that looks cloudy
- needing to pee suddenly or more urgently than usual
- needing to pee more often than usual
- lower tummy pain or pain in your back, just under the ribs
- a high temperature, or feeling hot and shivery
- a very low temperature below 36C
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How Long Should I Take Antibiotics
Your doctor will let you know. Typically, for an uncomplicated infection, you’ll take antibiotics for 2 to 3 days. Some people will need to take these medicines for up to 7 to 10 days.
For a complicated infection, you might need to take antibiotics for 14 days or more.
If you still have symptoms after completing antibiotics, a follow-up urine test can show whether the germs are gone. If you still have an infection, you’ll need to take antibiotics for a longer period of time.
If you get UTIs often, you may need a prolonged course of antibiotics. And if sex causes your UTIs, you’ll take a dose of the medicine right before you have sex. You can also take antibiotics whenever you get a new UTI if youâre having symptoms and a positive urine culture.
Fungal Urinary Tract Infection
Fungal UTI is uncommon. As with bacterial UTI, fungal UTI occurs because of temporary or permanent breaches in local or systemic immunity of the lower urinary tract. Funguria may be due to primary infections of the lower urinary tract or secondary to shedding of fungal elements into the urine in animals with systemic infections. Primary fungal UTI is most commonly due to Candida spp, a commensal inhabitant of the genital mucosa, upper respiratory tract, and gastrointestinal tract., Candida albicans is the most commonly identified species, followed by Candida glabrata and Candida tropicalis other ubiquitous fungi may also occasionally cause primary fungal UTI, including Aspergillus spp, Blastomycosis spp , and Cryptococcus spp.
Blastomyces spp organisms observed by microscopic examination of urine sediment from a 2-year-old castrated male Doberman pinscher.
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How Long Do I Need To Take Antibiotics To Treat A Uti
How long you take antibiotics for a UTI depends on how severe your UTI is and which antibiotic youre prescribed. Some medications like fosfomycin only require one dose, while a more severe UTI might require 14 days or more of treatment. Most require 3 to 7 days of treatment.
Within the first 1 to 2 days of starting your antibiotics, youll probably notice your UTI symptoms start to fade away. If your UTI is more severe or youve had symptoms for a while before starting antibiotics, it might take a few more days for you to notice improvement.
In any case, its important to take all the antibiotics youre prescribed, even if you start feeling better before finishing them. Stopping antibiotics early can lead to antibiotic resistance, which means the medication might not work as well as it should if you need it to treat an infection in the future. It can also mean your UTI might come back if you havent treated it completely.
Viral Urinary Tract Infection
Viral-induced disease in humans is increasingly recognized, especially of the upper urinary tract. However, it can be difficult to determine cause-and-effect relationships because viral-induced disease may occur in the absence of detectable replicating virus. Several viruses have been implicated in canine and feline disease .
Recurrent Urinary Tract Infections
Patients with three or more infections per year should be offered either continuous low-dose antibiotic prophylaxis, patient-initiated, or postcoital prophylaxis if the onset of infection is linked to sexual intercourse . Before a prophylactic regimen is chosen, a urine culture should be performed to determine the susceptibility of the pathogen. The duration of continuous prophylactic therapy is usually 6 months to a year. Unfortunately, within 6 months of discontinuing antibiotic prophylaxis, 40% to 60% of women develop a urinary tract infection, and prophylaxis must be resumed. Patient-initiated therapy at the onset of symptoms has been shown to be effective in young, healthy nonpregnant women. Short-course regimens have been advocated for patient-initiated therapy in compliant women with frequently recurring and symptomatic urinary tract infections. The major advantages of short-course therapy over continuous therapy are convenience and the avoidance of antibiotic toxicity symptomatic infections are not prevented, however. For postcoital prophylaxis, nitrofurantoin, trimethoprim-sulfamethoxazole, or fluoroquinolones taken within 2 hours after sexual intercourse have been shown to significantly reduce the incidence of recurrent cystitis.,
Treatment For A Uti Caused By E Coli
The first line of treatment for any bacterial infection is antibiotics.
- If your urinalysis comes back positive for germs, a doctor will likely prescribe one of several antibiotics that works to kill E. coli, since its the most common UTI culprit.
- If a urine culture finds a different germ is behind your infection, youll get switched to an antibiotic that targets that germ.
- You may also receive a prescription for a drug called pyridium, which helps reduce bladder pain.
- If you tend to get recurrent UTIs , you may need to be on low-dose antibiotics daily for a few months.
- Your doctor may also prescribe other medications for treatment that are not antibiotic based.
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Seek Medical Attention For Utis
It is important to seek medical attention if you think you may have a UTI particularly if you think you may have a bladder or kidney infection, both of which are very serious conditions. Early treatment of urinary infection can help to prevent infection spreading to the bladder or kidneys.
Your doctor will test your urine to check which micro-organism is present. Urinary tract infections usually respond quickly and well to antibiotics.
Whats The Difference Between A Urinary Tract Infection And Bladder Infection
A urinary tract infection is a more general type of infection. There are many parts of your urinary tract. A UTI is a term for an infection that takes place throughout the urinary tract. A bladder infection, also called cystitis, is a specific infection. In this infection, bacteria makes its way into the bladder and causes inflammation.
Not all urinary tract infections become bladder infections. Preventing the spread of the infection is one of the most important reasons to treat a UTI quickly when you have symptoms. The infection can spread not only to the bladder, but also into your kidneys, which is a more complicated type of infection than a UTI.
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Will I Need An Intravenous Antibiotic For A Uti
If you are pregnant, have a high fever, or cannot keep food and fluids down, your doctor may admit you to the hospital so you can have treatment with intravenous antibiotics for a complicated UTI. You may return home and continue with oral antibiotics when your infection starts to improve.
In areas with fluoroquinolone resistance exceeding 10%, in patients with more severe pyelonephritis, those with a complicated UTI who have allergies to fluoroquinolones, or are unable to tolerate the drug class, intravenous therapy with an agent such as ceftriaxone, or an aminoglycoside, such as gentamicin or tobramycin, may be appropriate. Your ongoing treatment should be based on susceptibility data received from the laboratory.
Treatment For Urinary Tract Infection
The best cystitistreatment is an antibiotic. Your dose and the type of antibiotic will depend on the severity of yourinfection as well as other factors, including:
- Side effects from past antibiotic treatments
Before your doctor prescribes you an antibiotic for UTI, he needs to determine the type of bacteriacausing the infection first. He will take a urine sample to confirm your infection. Samples of thebacteria will be grown in the lab for a couple of days. This culture will help your doctor determine thetype of bacteria thats causing the infection.
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Most Common Bacteria That Cause Utis
Based on a study by The National Center for Biotechnology Information, the bacteria most commonly associated with causing UTIs are:
- Escherichia coli
- Pseudomonas aeruginosa
Based on the symptoms the patient is experiencing and before any testing is done to officially determine the infection type, the doctor prescribes first line antibiotics. For most UTIs, the prescribed antibiotic will cure the infection and not require any further testing.
What If I Have Frequent Recurring Utis
Within a year of havig a UTI infection, roughy one-quarter to one-half of women will have another UTI. For these women antibiotic prophylaxis may be recommended by her health care provider. With a recurrent course of UTIs, a urine culture or imaging tests may be required for further analysis.
For recurrent UTIs, there are several antibiotic options for prevention:
- A shorter course of antibiotics at the first sign of UTI symptoms a prescription may be given to you to keep at home.
- A longer course of low-dose antibiotic therapy.
- Take a single dose of an antibiotic after sexual intercourse.
The choice of antibiotic is based on previous UTIs, effectiveness, and patient-specific factors such as allergies and cost. Antibiotics commonly used for recurrent UTIs can include sulfamethoxazole-trimethoprim, nitrofurantoin, cefaclor, or cephalexin.
In postmenopausal women with vaginal dryness that may be leading to recurrent UTIs, vaginal estrogen may be an effective treatment. Treatment options your doctor might recommend include: Estring, Vagifem , or vaginal estrogen creams .
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What Is A Urinary Tract Infection
UTIs are common infections that happen when bacteria, often from the skin or rectum, enter the urethra, and infect the urinary tract. The infections can affect several parts of the urinary tract, but the most common type is a bladder infection .
Kidney infection is another type of UTI. Theyre less common, but more serious than bladder infections.
How E Coli Enters The Urinary Tract
Urine is mostly made up of water, salt, chemicals, and other waste. While researchers used to think of urine as sterile, its now known that even a healthy urinary tract can host a variety of bacteria. But one type of bacteria not normally found in the urinary tract is E. coli.
E. coli often gains entry into the urinary tract via stool. Women are particularly at risk for UTIs because their urethra sits close to the anus, where E. coli is present. Its also shorter than a mans, giving the bacteria easier access to the bladder, where the majority of UTIs occur, and the rest of the urinary tract.
E. coli can spread to the urinary tract in a variety of ways. Common ways include:
- Improper wiping after using the bathroom. Wiping back to front can carry E. coli from the anus to the urethra.
- Sex. The mechanical action of sex can move E. coli-infected stool from the anus into the urethra and up the urinary tract.
- Birth control. Contraceptives that use spermicides, including diaphragms and spermicidal condoms, can kill the healthy bacteria in your body that protect you from bacteria like E. coli. This bacterial imbalance can make you more susceptible to a UTI.
- Pregnancy. Hormonal changes during pregnancy can affect the growth of certain bacteria. Some experts also think that the weight of a growing fetus can shift your bladder, making it easier for E. coli to gain access.
Diagnosing a UTI can involve a two-part process.
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