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Have a UTI? You Might Not Be Getting the Right Treatment

A close up of a medical document titled "diagnostic assessment" with "urinary tract infection" as the diagnosis. There are also antibiotics next to the paper.

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Key Takeaways

  • Urinary tract infections (UTIs) are common, especially for women. Approximately 50% of women experience a UTI in their lifetime.
  • According to a new study, uncomplicated UTIs are often not treated appropriately, especially for people living in rural areas.
  • People with UTIs are often given the wrong antibiotic or are prescribed an antibiotic for too long—both of which contribute to issues like antibiotic resistance.

A new study has found that it's common for people with uncomplicated urinary tract infections (UTI) to be given a treatment that is inappropriate. Additionally, people who live in rural settings are more likely to receive a prescription for antibiotics that is too long. 

The study was published in the journal Infection Control & Hospital Immunology in February 2021.

The research joins a growing body of evidence that doctors are often getting UTI treatment wrong. A 2018 study that included over 600,000 women diagnosed with a UTI found that over 75% of the prescriptions were for a longer time span than current guidelines recommend.

What Is a Urinary Tract Infection?

A urinary tract infection affects the organs that urine passes through, including the bladder, kidneys, and urethra. It often causes pain during urination, cloudy or bloody urine, or frequent urination. UTIs are typically caused by bacteria, and therefore, antibiotics are a common treatment. 

UTIs can be complicated or uncomplicated. Uncomplicated UTIs are common, especially in women, and are usually treated with an oral antibiotic. Complicated UTIs are more commonly seen in men and children, and may need to be treated with a longer course of antibiotics or antibiotics given through an IV.

Almost Half of Prescriptions Are Wrong

Researchers used past private insurance claims to identify uncomplicated UTIs in 670,450 women between the ages of 18 and 44 years old.

Next, the researchers looked for UTI treatments documented in the claims. Using clinical guidelines, they noted when a prescribed treatment was inappropriate.

Of the over 600,000 women with uncomplicated UTIs, 46.7% received an antibiotic that was inappropriate for treatment and 76.1% were prescribed antibiotics for a longer duration than generally considered necessary.

“This study helps shed light on the importance of providers using evidence-based guidelines for the treatment of such a common condition,” Brittany Robles, MD, MPH, CPT, an OBGYN, Certified Personal Trainer, and the owner of PostpartumTrainer.com tells Verywell.

Location Makes a Difference

The researchers also noted that the women who lived in rural areas were more likely to be prescribed longer courses of antibiotics than women in urban settings.

“These differences [among urban and rural women] may be related to several patient/provider level factors,” Pinkey Patel, PharmD, NASM-CPT, founder of TheSnapBack.com, tells Verywell. “For example, rural women were more likely to receive longer treatment durations, possibly in an effort to avoid treatment failure-related healthcare encounters that require travel. Provider specialty and prescribing patterns are also other potential factors.”

Why Is Inappropriate UTI Treatment Concerning?

Whether the wrong medication is prescribed or the correct medication is given for too long, incorrect UTI treatment has consequences—some of which reach beyond a single patient.

“For UTIs, we want to use the correct antibiotic and we want to treat for as short of a time as is necessary,” Lauren Demosthenes, MD, OBGYN, senior medical director with Babyscripts, tells Verywell. “Antibiotic stewardship speaks to using antibiotics only when necessary and using the right antibiotic for the right amount of time.”

Demosthenes says that the inappropriate use of antibiotics can cause side effects like allergic reactions and rashes. It can also contribute to antibiotic resistance, when “organisms build up a resistance to an antibiotic and that antibiotic no longer works well,” she says.

In fact, according to a study published in Clinical Infectious Diseases, patients with laboratory-confirmed antibiotic-resistant UTIs are more likely to experience delays in clinical recovery after treatment with antibiotics. 

Demosthenes says there are financial repercussions as well.

"On an individual level, antibiotics cost money for patients. On a societal level, the inappropriate use of antibiotics costs the health system money," she says. "Saving money on care that does not improve health can be used in other areas that do improve health.” 

Preventing UTIs

As the saying goes, an ounce of prevention is worth a pound of treatment. There are several things people can do to reduce their risk of getting a UTI.

Dietary Changes

One of the most popular remedies for UTI prevention is cranberry–especially for women. In a 2017 meta-analysis and systemic review published in the Journal of Nutrition, researchers found that after evaluating seven randomized controlled trials, ingesting cranberry reduced the risk of developing a UTI by 26%.

Fermented milk products containing probiotic bacteria (like kefir) are also associated with a decreased risk of recurrence of UTI, especially when consumed at least three times a week.

Lifestyle Changes

Along with the dietary changes, there are some other simple steps that you can take to keep your urinary tract healthy. 

Cory Ruth, MS, RDN, registered dietitian and a women’s health expert, tells Verywell that her top recommendation for preventing uncomplicated UTI is to urinate after having intercourse to help flush out any unwanted bacteria that potentially entered the urethra. 

Other lifestyle changes that can help prevent UTIs include:

  • Avoiding scented care products or those with ingredients that could be irritating
  • Not using bubble bath or bath bombs
  • Staying hydrated
  • Urinating frequently

If you do find yourself with a UTI, be proactive about your care. Ask your doctor to explain why the antibiotic that you're being prescribed is appropriate for the specific bacteria causing the infection, as well as why it is being prescribed for a specific duration.

What This Means For You

If you get a UTI, be proactive about your care. If your doctor prescribes antibiotics, discuss the benefits and risks of taking them—especially for a longer course. You can also do things to prevent getting a UTI, like staying hydrated.

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Article Sources
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