Yes, you need to finish the whole bottle.
There is nothing fun about getting a urinary tract infection (UTI). It makes it burn when you pee, you feel like you need to run to the john all of the time, and when you do, your urine smells kind of funky. UTIs are downright painful and frustrating, and for that you can thank the bacteria wreaking havoc in your body’s drainage system.
Thankfully, doctors know that antibiotics are some of the best treatments to wipe out those menacing germs—and fast! But figuring out the right prescription to beat your specific infection may be a bit of a process. And knowing how to properly take your meds could save you from future infection and other complications.
In order to help you understand what you need to know about antibiotics and UTIs, we’ve tapped on the pros: experts from MCG Health, a research company that compiles evidence-based guidelines so that patients and physicians can work together to create individualized care plans.
So, before you head to your next doctor’s appointment, read on: You’ll know exactly what to ask and what to expect, so you can say goodbye to that bothersome UTI.
What are the most common causes of UTIs?
Most of the time when you go #1, what flows out flushes away some of the troublesome microbes hanging out around your nether region.
“Usually urine is sterile so there’s no bacteria in it,” explains Sabitha Rajan, M.D., MSc, associate managing editor at MCG. “One of the things that keeps us sterile is its continuous flow. Urine flows out of your bladder, down and out your urethra [the emptying tube], and that flow keeps any bacteria from the outside from ascending.”
Proper hygiene helps keep bacteria at bay (that’s why when you were a kid, your parents may have told you to wipe front to back)—but even the cleanest among us can get a UTI. Keep an eye out for these common symptoms:
- A burning sensation when peeing
- A frequent urge to urinate (even when little to nothing is coming out)
- Bloody or cloudy urine
- Bladder cramps or pelvic pain
- And in the worst cases: fever, vomiting, and nausea
Women tend to be more susceptible to UTIs, partly because of the way their bodies are built, says Cheyenne Santiago, R.N., M.S.N., a managing editor at MCG. Men have a longer urethra that runs through the penis and farther away from the anus, so there is less of a chance for bacteria from stool and other sources to make their way to where they can cause problems.
“Women, on the other hand, have a very short urethra,” says Santiago. “So [women] can get bacteria forced up into your bladder.”
Sex can also increase the risk of UTIs in women and so Santiago and Dr. Rajan recommend going to the bathroom after intercourse.
Whichever the cause of your UTI, you should always schedule a visit with your primary care physician so they can get you the proper treatment.
What can I expect when I go to the doctor for a UTI?
Once you get to the doctor’s office, they are going to ask you about your symptoms and make you pee in a cup. This is called a “urinalysis” (analysis of your urine).
“They’ll look at it under a microscope and also dip it,” says Dr. Rajan. “The dipstick will tell the doctor very quickly if there’s any white blood cells, which is a sign of infection, or red blood cells, which could be a sign of some microscopic trauma.”
They will then send some of your pee off to a lab where they can test to see which bacteria is causing your infection. The results usually come back to you within one to two days. However, depending on how strongly your doctor feels that you have a UTI, they may put you on antibiotics right away. When the test arrives, they will double-check to see if they have selected the most effective meds to fight off the bacteria and make any needed adjustments.
How does the doctor decide which antibiotics to prescribe for my UTI?
There are three factors your doctor considers when they are deciding on an antibiotic, according to Dr. Rajan.
First, they need to make sure the medication they select will target the area that’s affected. For a UTI, your bladder is the organ that needs the TLC. Second, your docs will check for what they call “the local resistance pattern” in your town or city.
“There’s always a little bit of variation in the kinds of bacteria in a region,” explains Santiago. “That bacteria becomes more resistant to certain medications and those patterns are different from area to area. So, you may know that in the local area, a lot of women are coming in with a urinary tract infection and maybe a certain drug isn’t really working for them, and they really need another one instead because of the strain that we’re seeing.”
Your care team will also consider your medical history, like whether you’re allergic to penicillin, or if you are predisposed to certain bacterial infections. If cost is a concern, your physician may even be able to find a treatment that fits your budget or is supported by your insurance, says Santiago.
The most commonly used antibiotics for UTIs include:
Trimethoprim/sulfamethoxazole (Bactrim, Septra)
Nitrofurantoin (Macrodantin, Macrobid)
Make sure to ask your doctor which one they have prescribed you, so that you know what you are taking.
Why do I have to finish all of the antibiotics even if I feel better?
After a few days of taking the right antibiotics, you’re going to be feeling pretty good. Going to the bathroom will be a breeze. The inflammation will go down. But this might just mean you’ve only weakened the bacteria—not that you’ve completely zapped them out, says Santiago. It’s in this phase that the bacteria can come back with a vengeance and potentially become resistant to the meds that were your savior. So yes, finish the prescribed course even when you feel better.
Will antibiotics interfere with my birth control?
There was a time when doctors often recommended that women on birth control have a backup barrier method, such as a condom, whenever they had to take antibiotics. But Santiago says that the science on this isn’t very clear. Recent research has discovered a correlation between antibiotic use and unintended pregnancies while other studies have not found that connection.
“So, this is really something that women need to discuss with their physicians about whether or not there is a potential for lowering the effectiveness of their birth control and whether or not they need to add that barrier contraceptive,” suggests Santiago.
How do antibiotics affect my gut health?
Here’s the thing about antibiotics: They kill the good bacteria along with the bad. This means as the meds make their way down to the bladder, they can harm some of the microbiome, which is important for your digestion, regulating your immune system, and other functions researchers are beginning to unpack.
Because of that, doctors will sometimes recommend patients with recurring UTIs take probiotics along with their antibiotics. The theory is that this will re-seed the gut or at least prevent the medicine from killing off too much of the good stuff, says Santiago. However, according to Dr. Rajan, there isn’t enough scientific research to say if this approach is effective.
“When you’ve finished the antibiotic, you can try to increase your intake of fermented foods and yogurts,” says Dr. Rajan. “There’s some evidence that those foods can provide those good bacteria. But I say that with the caveat that we are still learning more about this.”
Do antibiotics have any negative side effects?
While many people do not have any severe negative reactions to antibiotics, these medications have potential side effects. If you have ...
A yeast infection
... while you’re taking your medication, see your doctor as soon as possible. If you have a severe allergic reaction, head straight to urgent care.
Are there natural alternatives to treat UTIs?
There are no known effective alternative treatments, but cranberry juice and cranberry juice extract pills may be able to help stop infections from occurring in the first place. Cranberry has a naturally occurring compound that can help prevent some bacteria from sticking to your urethra, says Dr. Rajan.
“But it’s a very small effect, if any,” she adds. Just drinking enough fluids can be enough to keep everything flowing and minimize harmful bacteria. But if you enjoy drinking cranberry juice and it doesn’t give you a tummy ache, there’s no harm in trying it to prevent UTIs—not to treat. If you’re on blood-thinners, however, experts say, “stay away.”
Bottom line: Seek treatment for a UTI immediately.
Antibiotics can be really powerful when it comes to treating urinary tract infections—especially when they are caught early. Untreated UTIs can lead to kidney infections and other serious complications. So, when you feel like you have one, go see your primary care doctor as soon as you can, and talk about which treatment would be best for you.
By Adele Jackson-Gibson