Treatment Options for UTIs

Written By: Amy Harris, MPH, RN

If you have ever had a urinary tract infection (UTI), you are not alone. UTIs are one of the most common bacterial infections and there are more than 8 million healthcare visits for UTI symptoms each year. [1,2] While antibiotics (a class of medications used to kill bacteria) are the only way to cure your UTI, home remedies and over-the-counter (OTC) medications can help ease your symptoms.

Antibiotic Treatment of UTIs

Antibiotics are the most effective medication for a UTI. They must be prescribed by a doctor, nurse practitioner, nurse midwife, or physician assistant. They can be prescribed in person or via telehealth on with a company like Everlywell.

The type, dose, and length of antibiotic treatment depend on the type of bacteria causing the infection and your medical history. Usually, you take antibiotic pills for a few days, and your symptoms should go away in one to two days. It’s very important to finish all of your medication for the UTI, even after your symptoms go away. This reduces the chance of having recurring UTIs and antibiotic resistance.

What Are the Differences Between OTC Medications and Antibiotics?

The most important difference is that only antibiotics can cure a UTI by killing the bacteria causing the infection. No OTC treatments have been shown to treat UTIs as effectively as antibiotics. OTC medications such as Azo® or Cystex® only provide symptom relief. The two main OTC medications for UTI symptoms are Azo® and Cystex®.

Azo® contains phenazopyridine (pyridium), a chemical known to “numb” your urethra so you don’t feel uncomfortable pain or burning when peeing. Azo® can relieve pain and burning when peeing within 20-30 minutes of taking it. You need to take Azo® three times a day, and doing so may make you think (incorrectly) that your UTI is cured by taking away your symptoms. [4] Cystex® contains two chemicals: methenamine and salicylate, a nonsteroidal anti-inflammatory drug (NSAID). Methenamine prevents bacteria from growing, and salicylate helps reduce pain. Studies have shown that methenamine may help prevent recurrent UTIs. Still, it has not been shown to work as well as antibiotics in treating UTIs, especially at the lower OTC dosage amount. [5]

It is safest to use Azo® and Cystex® once you have started antibiotics while you wait for them to start working. If you have not started antibiotics and have been using these OTC medications for symptom relief for longer than two days, it is a good idea to check in with a healthcare provider about your continued symptoms.

Other Supplements or “Natural” UTI Treatments You May Have Heard About

The pharmacy shelves and online marketplaces offer a confusing assortment of supplements and treatments, all claiming to be just what you need to treat your UTI. Some OTC medications mentioned above, like Cystex® and Azo®, even mix “natural” remedies into combination products. Some ingredients you might see are:

Cranberry Extract

Cranberry extract is one of the most commonly recommended home remedies for UTIs. Drinking unsweetened cranberry juice or extract supplements may help prevent repeat urinary tract infections, but they do not treat UTIs like antibiotics do. [6] Sweetened cranberry juice is high in added sugars and is a food source for bacteria, so try to drink unsweetened cranberry juice for UTI prevention.

Probiotics

Probiotics are types of “good” bacteria that naturally live in our gut and bodies. They have been shown to help boost immunity (your ability to fight off infection) and maintain digestive health. [7] However, research studies looking at how effective probiotics are for UTI prevention are inconclusive. [8] Eating yogurt, kefir (a yogurt drink), and fermented foods and drinks such as kombucha, sauerkraut, or kimchi may help keep away future UTIs and restore your gut’s healthy mix of bacteria after taking antibiotics for your UTI.

D-Mannose

This type of natural sugar may help prevent the recurrence of UTIs, although very few research studies have proven that taking D-mannose actually decreases the number of UTIs. [8,9]

Vitamin C and Other Immunity-Boosting Supplements

Vitamin C, garlic, zinc, and magnesium might help you avoid getting a UTI by boosting your immune system’s natural defenses against infections, but they are not UTI treatments. Theoretically, vitamin C could also help you kick your UTI quicker by increasing the acidity of your urine and killing off UTI-causing bacteria. However, research studies have not sufficiently confirmed this. [10]

While some research-based supplements, such as D-mannose and cranberry extract, have been shown to ease UTI symptoms or reduce the chances of getting another UTI, your safest bet for getting rid of your UTI is to treat it with antibiotics.

UTI Home Remedies To Help Ease Your Symptoms

Still looking for some natural UTI relief? In addition to antibiotics, supplements, or OTC medications, many people also find some home remedies helpful in preventing recurrent UTIs and keeping them more comfortable if they have UTI symptoms. Try some of these tips and tricks to help you to start feeling better [11-12]:

• Place a heating pad over your lower abdomen or pelvis to help ease cramping, aches, or pain.
• Stay hydrated and drink plenty of water to help flush out bacteria.
• Avoid drinks and foods that could be irritating to your bladder or urethra, such as caffeinated beverages (coffee, tea, energy drinks), sugary foods and drinks, carbonated beverages, artificial sweeteners, alcohol, and acidic foods like citrus and tomatoes.
• Make sure to empty your bladder completely, especially before bed. While it can sometimes be harder to empty your bladder completely when you have a UTI, taking your time on the toilet and sitting in a relaxed position while peeing helps to ensure that no bacteria-containing urine is left behind to keep growing in your bladder or urethra overnight.
• OTC pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs), like Advil or Motrin (ibuprofen), aspirin, Aleve (naproxen), or Tylenol (acetaminophen) can all help make peeing less painful, ease any other aches and pains, and lower your fever if you are running one.

Why Do Women Have More UTIs Than Men?

Anatomy is the reason why women have more UTIs than men. Female urethras are shorter and closer to the rectum, making it easier for bacteria to enter the urinary tract. Half of all women will have at least one UTI in their lifetime. [3]

Many women have multiple UTIs several times over their lifetime.[2] One out of every four women will have recurrent UTIs. [3] Healthcare providers diagnose recurrent UTIs if someone has at least three repeated infections per year or two infections in the preceding six months. [2]

What Are the Most Common Symptoms of a UTI?

The most common symptoms of a UTI are:

• Pain with urination
• Burning when peeing
• Foul-smelling urine
• Cloudy urine
• Pelvic pain or back pain, usually dull and aching
• Urinary urgency or feeling like you need to pee more often

Sometimes, you might feel like your UTI symptoms are coming and going. This can happen if the right antibiotic is not prescribed for your UTI. Sometimes UTIs can come back, even if you are prescribed an effective antibiotic. Another reason why your symptoms may come and go is antibiotic resistance. Antibiotic resistance happens when antibiotics become less effective over time, a circumstance called antibiotic resistance.

When to Seek Telehealth Services for Quick Prescriptions

Ongoing symptoms (for more than one to two days) may mean that your UTI is getting worse and that the OTC treatments or home remedies you tried are not working. It is time to consult a doctor or healthcare provider if you have any of the following symptoms: [11]

• Blood in your urine
• Fever or chills
• Back or side (flank) pain
• Nausea or vomiting

If you have any of these symptoms, it is important that you see a healthcare provider sooner rather than later to avoid a more severe infection. Complications can occur if the infection in your urinary tract spreads to your kidneys or bloodstream. A kidney infection (called pyelonephritis) can cause kidney scarring and damage. [13]

Untreated kidney infections can spread to your bloodstream (sepsis) and cause life-threatening infections. In men, an untreated UTI or pyelonephritis can damage the prostate. [13]

When it comes to UTIs, getting the correct diagnosis and the right antibiotic should be your first step. Prompt diagnosis and treatment with the right antibiotic can help you avoid these complications.

Get Better Urinary Health Today With Everlywell Virtual Care

While home remedies such as cranberry extract, probiotics, or D-mannose and OTC medications like Azo® or Cytex® may bring you temporary relief from your UTI symptoms, antibiotics are the only way to cure your UTI. Given that UTI diagnosis and treatment can help you avoid further complications, you may be wondering where you can get antibiotics quickly.

With virtual care from Everlywell, you can connect with an expert healthcare provider right away from your phone, tablet, or computer. There are no long waits for appointments, embarrassing trips to a laboratory, or mishaps at the pharmacy. If you are wondering whether you have a UTI or are not getting relief from home remedies or OTC treatments, Everlywell can help you feel your best faster and with fewer hassles.

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References

1. Bono MJ, Leslie SW, Reygaert WC. Uncomplicated Urinary Tract Infections. [Updated 2023 Nov 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.Medical Citation URL.
2. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 91: Treatment of urinary tract infections in nonpregnant women. Obstet Gynecol. 2008;111(3):785-794.Medical Citation URL.
3. Kodner CM, Thomas Gupton EK. Recurrent urinary tract infections in women: diagnosis and management. Am Fam Physician. 2010;82(6):638-643. Medical Citation URL.
4. Eastham jH, Patel P. Phenazopyridine. [Updated 2023 May 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Medical Citation URL.
5. Harding C, Mossop H, Homer T, Chadwick T, King W, Carnell S et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial BMJ 2022; 376 :e068229 doi:10.1136/bmj-2021-0068229.
6. Williams G, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2023;4(4):CD001321. Published 2023 Apr 17. doi:10.1002/14651858.CD001321.pub6
7. Should You Take Probiotics? Harvard Health Publishing. Published July 2, 2022. Accessed November 6, 2024. Medical Citation URL.
8. Ala-Jaakkola R, Laitila A, Ouwehand AC, Lehtoranta L. Role of D-mannose in urinary tract infections - a narrative review. Nutr J. 2022;21(1):18. Published 2022 Mar 22. doi:10.1186/s12937-022-00769-x
9. Cooper TE, Teng C, Howell M, Teixeira-Pinto A, Jaure A, Wong G. D-mannose for preventing and treating urinary tract infections. Cochrane Database Syst Rev. 2022;8(8):CD013608. Published 2022 Aug 30. doi:10.1002/14651858.CD013608.pub2
10. Sihra, N., Goodman, A., Zakri, R. et al. Nonantibiotic Prevention and Management of Recurrent Urinary Tract Infection. Nat Rev Urol. 2018;15, 750–776. Medical Citation URL.
11. Urinary Tract Infection Basics. CDC. Published January 24, 2024. Accessed November 4, 2024. Medical Citation URL.
12. Foods and Drinks That Can Irritate Your Bladder. Cleveland Clinic Health Matters. Published June 14, 2023. Accessed November 6, 2022. Medical Citation URL.
13. Urinary Tract Infections in Adults. Urology Care Association. Updated November 2022. Accessed November 6, 2024. Medical Citation URL.