CLARIFICATION OF TERMS:

When most people use the words Urinary Tract Infection or UTI, they are usually referring to a Bladder Infection. However, there is no specific term for Bladder Infection. There is a term called “Cystitis”—but this term only refers to an inflammation that occurs in the bladder—NOT an INFECTION that occurs in the bladder. Therefore, the term Urinary Tract Infection is usually used. The problem with this term is that it does not specify which part of the Urinary Tract is infected. Is it a Kidney infection? A Ureter infection? A bladder Infection? Or is it an infection or inflammation of the Urethra?

But, since most of the time, if a person has an infection in their Urinary Tract, this infection will be in their Bladder; the words Urinary Tract Infection is usually used to refer to an infection that is occurring in their bladder.
 


 

* Urinary Tract Infection (UTI, Bladder Infection, Cystitis)
 

WHAT ARE THE SYMPTOMS OF A URINARY TRACT INFECTION (UTI) OR (BlLADDER INFECTION)?

The symptoms of a Urinary Tract Infection usually include mild lower abdominal discomfort and frequent urination. Often women report a mild pain toward the end of urinating. Sometimes women report they can see blood in their urine and their urine smells bad.

WHAT CAUSES A URINARY TRACT INFECTION (UTI) OR (BLADDER INFECTION)?

Most causes of a Urinary Tract Infections or Bladder Infections are caused by bacteria that migrate up the urethra to the bladder.

The most common cause of a Bladder Infection (75-95%) is a bacteria called Escherichia Coli (E. Coli). It is in every human colon. And what normally happens is that E. Coli migrates from around the anus area, up the urethra to the bladder, and hence a Bladder Infection occurs. The normal bladder does NOT have any bacteria. Other gram negative bacteria that could cause a Urinary Tract Infection are the following: Klebsiella, Proteus Mirabilis, Pseudomonas Aeruginosa.

The most common gram positive bacteria that can cause a UTI is Staphylococcus Saprophyticus is isolated in 5 to 10% of bacterial UTIs. Two other gram positive bacteria that can cause a UTI are the following: Enterococcus Faecalis (Group D Streptococci) and Streptococcus Agalactiae (Group B Streptococci).

HOW IS A UTI (BLADDER INFECTION) DIAGNOSED?

A bladder infection is usually diagnosed by a careful history. A physical exam is helpful to check for lower abdominal discomfort and back pain in the area of the kidneys. Laboratory test are also helpful. The urine can be checked in the office for signs of white blood cells, red blood cells, and nitrites. The urine can be examined under a microscope as well. In addition, the urine can be sent to a lab for a culture that will look for the specific cause of the UTI, and the antibiotics that will help the best to treat the infection.

HOW IS A UTI (BLADDER INFECTION) TREATED?

* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.

ANTIBIOTICS for non-pregnant, non-complicated infection

A. Nitrofurantoin (Macrobid) * 100 mg orally twice a day for 5 days (But it is contraindicated if creatinine clearance is < 60 mL/min)

B. Fosfomycin * 3 g orally once

C. Trimethoprim/sulfamethoxazole * (TMP/SMX) 160/800 mg orally twice a day for 3 days

If there a possible Kidney Infection (Pyelonephritis)

A. Ciprofloxacin * 500 mg orally twice a day for 7 days

B. Levofloxacin * 750 mg orally once a day for 5 days < 10% of the bacteria in the community are resistant

C. TMP/SMX 160/800 * mg orally twice a day for 14 days. In some parts of the US, > 20% of E. coli are resistant to sulfa

D. Augmentin *

E. Gentamycin IM MIGHT be consider in some circumstances
F. Doxycycline MIGHT be consider in some circumstances

D. Intravenous antibiotics are sometimes used when a person has a bacteria in their bladder or kidneys that are difficult to kill.
a. Gentamycin *
b. levofloxacin *
c. Ciprofloxacin *
d. meropenem *
e. piperacillin/tazobactam *
f. ampicillin *
g. ceftriaone (Rocephin) *

CAUTION:

1. If a person has both Urinary Tract Infection Symptoms and back pain (in the area of the kidneys or the ureters), that person may have a Kidney Infection and needs antibiotics that treat a kidney infection in addition to the bladder infection.

2. There are other organism (other than bacteria) that can cause a UTI. Urinary Tract Infections can also be caused by fungi, viruses, and parasites. The only parasite that occurs in the United States is Trichomonad Vaginalis, which is usually contracted through sex.

3. Most Nonbacterial pathogens (except Trichomonad Vaginalis) only effect patients who are immunocompromised, have diabetes, have a urinary tract abnormalities, or have had some type of recent urinary tract examination.

4. If a person has More Mucous Drainage and Burning Sensation from their urethra than is typical for a UTI, they should be tested for a sexually transmitted disease: Gonorrhea, Chlamydia, Trichomoniasis.

5. Although antibiotic pills can sometimes be used to treat a bladder infection, they are not always effective. If you are not feeling better in 24 hours, contact your provider and let them know. You may need a stronger or different antibiotic.

6. All medication, including all antibiotics, have a risk of side effects.

7. Possible mild side effects are nausea, vomiting, diarrhea, itching, and light to moderate skin rash.

8. Possible severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), or Clostridioides difficile infection (C-Diff)

Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.