Best treatments for UTI

Causes and Symptoms of UTIs

UTIs happen when bacteria, most often Escherichia coli (E. coli), enter the urinary tract and grow, causing an infection. Women are especially prone to UTIs because their urethra (the tube that carries urine out of the body) is shorter and closer to the rectum, making it easier for bacteria to enter the bladder.1,2

Other risk factors for UTIs include:

• sexual activity
• certain types of birth control, like diaphragms or spermicides
• structural abnormalities in the urinary tract
• blockages like kidney stones that disrupt urine flow
• a weakened immune system due to illness or medications1,5
• pregnancy
• diabetes
• catheter use7,14

Older adults, especially those in long-term care facilities or with cognitive impairments like dementia, are at higher risk for UTIs because of incontinence, difficulty communicating symptoms, and weakened immune systems.3,4 In these people, UTIs may present with subtle or atypical symptoms like confusion or behavioral changes, which makes diagnosis more difficult.

The symptoms of a UTI vary depending on which part of the urinary tract is infected. Lower UTIs, which affect the bladder and urethra, often cause:

• burning with urination
• increased frequency or urgency of urination
• pelvic pain
• cloudy or blood-tinged urine
• strong-smelling urine1,2

Upper UTIs, which involve the kidneys, can cause additional symptoms like fever, chills, back pain, nausea, and vomiting.2,3

It's important to seek treatment for UTIs promptly. Left untreated, UTIs can lead to serious complications like permanent kidney damage or life-threatening sepsis.2,3

Diagnosis and Testing for UTIs

Fast and accurate diagnosis is important for effectively treating UTIs and preventing complications. If you suspect you have a UTI based on your symptoms, it's important to see a healthcare provider for evaluation. Your provider will likely start by taking a thorough history, asking about your symptoms, risk factors like sexual activity or birth control use, and any prior UTIs. They also may perform a physical exam to check for tenderness over the bladder or kidneys.13,14

Your provider will need a urine sample to confirm the diagnosis. They will run a urinalysis, a test that looks for white blood cells, red blood cells, bacteria, and other signs of infection.15,16 Often, a urine culture will also be ordered, where a lab will identify the specific bacteria causing the infection and help your provider decide which antibiotics would be most effective for treatment.15,17

In some cases, additional testing may be recommended. For example, if you have recurrent UTIs or your healthcare provider suspects an underlying anatomical issue, imaging tests like an ultrasound or CT scan, or procedures like a cystoscopy (which uses a small camera to examine the bladder), may be ordered.2,4

While over-the-counter UTI test strips are available, these should not be used in place of a professional evaluation. Home tests can miss infections.17,20 Even if you test positive on a home test, it's still important to follow up with a healthcare provider for a complete assessment and the right treatment.34,36

Antibiotic Treatments for UTIs

Antibiotics are the main treatment for UTIs. These medications work by killing the bacteria causing the infection. The choice of antibiotic depends on the type of bacteria involved, the severity of symptoms, and your overall health.21,22

For uncomplicated lower UTIs, short courses of oral antibiotics are usually enough. Commonly prescribed options include nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole.22,38 These medications are generally well-tolerated and effective at clearing the infection.

If you are prescribed antibiotics for a UTI, it's important to take them exactly as directed, even if you start feeling better before finishing the course. Stopping treatment too soon can lead to antibiotic resistance and recurrent infections.37,40

Natural and Home Remedies for UTIs

In addition to medical treatment, there are several natural and home remedies that may help manage UTI symptoms and support recovery. While these approaches should not be used as a substitute for antibiotics, they can be a helpful addition.

One of the most well-known natural remedies for UTIs is cranberry. Cranberries contain compounds called proanthocyanidins (PACs) that may prevent bacteria from sticking to the lining of the urinary tract.7,8 Some studies have found that cranberry supplements or juice can reduce the risk of recurrent UTIs, especially in women who have frequent infections.9,10

Another potential natural remedy is D-mannose, a type of sugar that is thought to stop bacteria from sticking to the bladder wall.

Probiotics, which are beneficial bacteria that help maintain the natural balance of microorganisms in the body, have also been studied for UTI prevention and treatment. Certain strains of Lactobacillus may reduce the risk of recurrent infections.8,11

In addition to these remedies, there are several self-care habits that can help manage UTI symptoms and speed recovery:

• Drinking plenty of water to help flush out bacteria
• Applying a heating pad to the abdomen or back to relieve pain and discomfort
• Taking over-the-counter pain relievers like acetaminophen or ibuprofen
• Avoiding irritating foods and beverages, like caffeine, alcohol, and spicy foods
• Wearing loose, breathable clothing and cotton underwear4,5

While these home remedies may provide some relief, they are not a replacement for medical care.

Preventing Recurrent UTIs

For some people, UTIs are not just a one-time problem. About 1 in 4 women who get a UTI will have another one within six months, and some people experience three or more UTIs in a year.31,43

There are several factors that can increase the risk of recurrent UTIs, including:

• Having your first UTI at a young age
• Frequent sexual activity
• Using spermicides or diaphragms for birth control
• Having diabetes or other conditions that weaken the immune system
• Structural abnormalities or blockages in the urinary tract33,35

To prevent recurrent UTIs, healthcare providers may recommend a combination of strategies:

• Drinking plenty of water to maintain regular urinary flow and flush out bacteria
• Urinating shortly after sexual activity to clear any bacteria
• Wiping from front to back after using the toilet to prevent bacterial spread from the anus
• Avoiding irritating feminine products, like douches or scented tampons
• Taking a daily low-dose antibiotic or a single dose after sexual activity31,33

For postmenopausal women, vaginal estrogen therapy may also be helpful. The drop in estrogen levels after menopause can change the bacterial balance in the vagina and make UTIs more likely. Applying a low-dose estrogen cream or inserting an estrogen-releasing ring into the vagina can help fix this imbalance and reduce UTI risk.26,27

If you experience frequent UTIs, it's important to consult with a healthcare provider. They can help identify and treat any underlying conditions or anatomical issues that may be contributing to the problem.44 In some cases, additional methods like intravesical antibiotic instillations (flushing out the bladder) may be recommended for people with specific risk factors like neurogenic bladder.44,45

Preventing recurrent UTIs often needs a personalized approach. Working closely with a healthcare provider can help you find the right combination of medical treatments, lifestyle changes, and natural remedies to maintain urinary health.46

Conclusion

Urinary tract infections are a common but potentially serious problem. By understanding the causes, symptoms, and risk factors for UTIs, you can take steps to protect your urinary health and get prompt treatment if an infection does occur.

If you suspect you have a UTI, don't hesitate to see a healthcare provider. While home remedies like cranberry and D-mannose may provide some relief, they are not a substitute for proper medical care. Antibiotics are the main treatment for most UTIs.

For people with recurrent UTIs, prevention is key. This may involve a combination of lifestyle modifications, medical interventions, and natural approaches, like cranberry supplements or probiotics. Your healthcare provider can help you develop a personalized plan based on your risk factors and preferences.

Citations:

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<34>Vetting: The products on our list have been vetted to ensure that they align with Healthline's brand integrity standards and approach to well-being. You can read more about our vetting process. An at-home UTI test is a tool or kit you buy over-the-counter (OTC) or online to test whether you have a UTI infection. (Healthline, 2022)</34>

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<42>Buck, E. S., Lukas, V. A., & Rubin, R. S. (2021). Effective Prevention of Recurrent UTIs With Vaginal Estrogen: Pearls for a Urological Approach to Genitourinary Syndrome of Menopause. Urology, 151, 31-36. https://doi.org/10.1016/j.urology.2020.05.058</42>

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<44>Cameron, A. P., Castrodad, P. M., Troost, J., Forchheimer, M., & Tate, D. G. (2022). Effectiveness and patient perspective on the use of intravesical gentamicin instillations to treat recurrent urinary tract infections in neurogenic lower urinary tract dysfunction. Neurourology and Urodynamics, 41(1), 280-287. https://doi.org/10.1002/nau.24860</44>

<45>Pietropaolo, A., Giannantoni, A., Massoud, A. M., Tariq, R., Sener, T. E., Sener, G., ... & Kessler, T. M. (2018). Intravesical antimicrobial instillation for the treatment and prevention of recurrent urinary tract infections: a systematic review of the literature. Urologia Internationalis, 100(3), 271-288. https://doi.org/10.1159/000486212</45>

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