Your treatment plan
Your recommended treatment plan will depend on whether you have a lower or an upper urinary tract infection (UTI). A lower UTI can usually be treated at home using antibiotics, as can cases of mild to moderate upper UTI. More serious cases of upper UTI, or cases that develop in people with pre-existing risk factors that increase the risk of complications, will require hospital treatment.
Lower UTI - treatment at home
Treatment at home for a lower UTI usually involves taking a three to seven day course of an antibiotic. The exact length of the course will depend on whether you have an increased risk of developing complications.
Trimethoprim is an antibiotic that is often used to treat cases of lower UTI. Side effects of trimethoprim are uncommon and they are usually mild. They include:
- nausea
- vomiting
- skin rash
- itchy skin
Over-the-counter (OTC) painkillers, such as paracetamol or ibuprofen, can be used to relieve symptoms of UTI such as abdominal pain.
Upper UTI - treatment at home
Treatment at home for an upper UTI usually involves taking a seven to fourteen day course of antibiotics. Again, the length of the course will depend on your risk of developing complications.
Antibiotics called co-amoxiclav or ciprofloxacin are usually used, unless you are pregnant, in which case an alternative antibiotic called cefalexin, which is known to be safe to be used during pregnancy, can be used instead.
These antibiotics can cause drowsiness, so while you are taking them avoid driving and operating complex or heavy machinery.
Make sure you drink plenty of fluids as this will help to relieve your symptoms of fever, and will also help to prevent dehydration.
Paracetamol can be used to treat the associated symptoms of an upper UTI. However, you should not use the non-steroidal anti-inflammatory drug (NSAID) type of painkiller, such as ibuprofen or naproxen, because they can increase the risk of developing kidney complications.
Treatment at hospital
You may be admitted to hospital if you have an upper UTI and:
- you are pregnant
- you are over 60 years of age
- you have symptoms of severe vomiting
- you have symptoms of severe pain
- you are dehydrated
- you are unable to pass urine, or the amount of urine you are passing is severely reduced
- you have a blockage in your kidneys, such as a kidney stone
- you have diabetes
- you have been undergoing chemotherapy and/or radiotherapy
- you have a previous history of kidney disease
- you have a previous history of recurring upper UTIs
- you have HIV
- you have sickle-cell anaemia
- you have cancer
If you are admitted to hospital with an upper UTI, you will probably be attached to a drip so that you can be given fluids to help keep you hydrated. Antibiotics can also be administered through the drip.
You will be given regular blood and urine tests so that your health can be carefully monitored, and to measure the effectiveness of the antibiotics at fighting off the infection.
Most people who are admitted to hospital to be treated for an upper UTI respond well to treatment and are able to leave hospital within three to seven days.
Treating recurring UTIs
If you have repeated and recurring UTIs, further treatment may be required to prevent permanent damage to your urinary tract.
If it is thought that the recurring UTIs are due to your urethra becoming irritated after sexual intercourse, you may be given antibiotic tablets. You should take a tablet after each time that you have sex, ideally in the first two hours after intercourse.
If you are using a diaphragm or spermicide-coated condom as your main method of contraception, you may want to consider using another method that does not increase your risk of developing UTIs, such as the contraceptive pill.
If the recurring UTIs are not thought to be linked to sexual intercourse, you may be given a low-dose antibiotic to take daily.
A medication called methenamine hippurate is an alternative to taking antibiotics. Methenamine hippurate works by changing the chemical composition of your urine, making it ‘less attractive’ to bacteria.
Side effects of methenamine hippurate are uncommon and include:
- skin rashes
- itchy skin
- indigestion
Methenamine hippurate is not as effective as antibiotics in preventing the return of infection. Therefore, it tends to be used only when people are unable or unwilling to take antibiotics.
There are also some lifestyle changes that you can make to reduce the risk of UTIs. See UTI, adults - prevention for more information.
