Urinary Tract Infection Treatment

Urinary Tract Infection Treatment. Typical symptoms of a urinary tract infection are burning pain when urinating or increased urination. Behind this is an infectious disease that is caused by bacteria in most cases. The therapy depends on the type and cause of the infection. What distinguishes men and women and how to prevent a urinary tract infection.

The fact that women more often suffer from urinary tract infections, has mainly anatomical reasons: Most of the pathogens of infection (mostly bacteria ) pass through the urethra into the urinary tract. Inflames the tissue ( urethritis , cystitis ), there is a lower urinary tract infection . Since women have a shorter urethra than men , it can be particularly easy to develop a urinary tract infection.

What is a urinary tract infection?

urinary tract infection is a disease of the urinary tract caused by certain pathogens. Depending on where the urinary tract infection is located, physicians distinguish lower and upper urinary tract infections:

  • lower urinary tract infection occurs when the urethra (urethra) or the bladder is affected and an inflammation of the urethra (urethritis) or a bladder infection (cystitis) has been created.
  • An upper urinary tract infection is formed when the infection on the ureter (ureter) and kidney spreads and to a kidney infection (pyelonephritis) comes. Untreated, this inflammation in severe cases, a type of blood poisoning(urosepsis).

Urinary Tract Infection Treatment

As a rule, bacteria trigger a urinary tract infection. Doctors differentiate between two forms of urinary tract infection , depending on the cause :

  • An uncomplicated urinary tract infection is an infection caused solely by pathogens, in which there are no favorable risk factors. Often such urinary tract infections heal on their own. In some cases, antibacterial therapy ( antibiotics ) is required.
  • complicated urinary tract infection is present, if an underlying disease exists (eg diabetes mellitus ) or if the urinary tract next to the infection additionally disturbed in its function or in its structure is changed (eg by foreign bodies, urinary stones, enlarged prostate , tumors ). If the beneficial factors are not eliminated, there is a risk of chronic urinary tract infection.        

Distinction between urinary tract infection and cystitis:

The bladder is – as is the inflammation of the urethra ( urethritis) – a  lower urinary tract infection. So it affects only the bladder, while generally a urinary tract infection may also affect the upper urinary tract.

A lower urinary tract infection affects the urethra or bladder: Then there is a urethral or bladder infection. If the infection spreads to the ureters and kidneys, the result is an upper urinary tract infection – for example, a pyelonephritis.

Typical symptoms of a urinary tract infection

A urinary tract infection can be without noticeable symptoms. About five to ten out of a hundred women with a urinary tract infection are completely symptom free . Nevertheless, there are typical symptoms.

  • Burning while urinating
  • increased urination
  • attenuated urinary stream
  • Pain in the lower abdomen
  • Difficulty keeping the urine
  • Blood in the urine , resulting in the slightest degree of intense red coloration of the urine

Depending on how severe the urinary tract infection is, the symptoms may vary in each individual case . Which symptoms occur depends on which structures are affected by the inflammation:

  • If only hollow organs (bladder, urethra) are affected by the urinary tract infection, febrile symptoms often remain.
  • If, on the other hand, the kidneys are involved in the urinary tract infection (so-called pyelonephritis ) or if the infection is particularly severe , a fever typically occurs .

Such a severe urinary tract infection can cause other symptoms such as chills , severe pain (in the lower abdomen, but also in the lateral abdominal area, in the perineal and genital area) and a general feeling of sickness, which resembles a flu . Also, nausea and vomiting can accompany a strong urinary tract infection.

urinary tract infection Causes

A urinary tract infection usually arises from bacteria that rise above the urethra . These are predominantly intestinal bacteria of the type Escherichia coli , which originate from the own stool.

In rare cases, other pathogens are responsible for the urinary tract infection, such as bacterial pathogens that are typical of certain sexually transmitted diseases: for example,  chlamies or gonococci (gonorrhea) or fungi or viruses . Rarely do the causative agents reach other sources of infection via the bloodstream into the urinary tract (so-called hematogenous infection).

There are many factors that can favor a urinary tract infection .

  • congenital malformations of the urinary tract
  • Urinary stones ( kidney stones or bladder stones )
  • Diabetes mellitus
  • Permanent urinary catheter
  • weakened immune system
  • tumors

Those who do not drink enough excrete less urine. This can also promote a urinary tract infection. In a permanent catheter – a thin, flexible plastic tube, which drains urine from the bladder via the urethra – as well as in diabetes mellitus, fungi are often the cause of a urinary tract infection.

Urinary tract infection in women and men

Adult women  (especially if they are sexually active) are four times more likely to have urinary tract infections than men of the same age . They have a much shorter urethra and their urethra opening is relatively close to the anus, so that intestinal bacteria can easily enter the urethra.

Special features of women

In women, a urinary tract infection is usually uncomplicated: Urinary Tract Infection Treatment accordingly, it takes usually only two to three days, until the urinary tract infection disappears completely. The symptoms sometimes even go away by themselves.

However , symptoms of urinary tract infection during pregnancy may be more severe . The same applies to the urinary tract infection in children .

Urinary tract infections in men

Men are more likely to have a complicated urinary tract infection than women. If they have a prostate infection in addition to the urinary tract infection , blood can be in the sperm . In addition, a urinary tract infection in men can bring more symptoms, such as disorders of sexual desire, erection and ejaculation and discomfort in the rectum.

Since boys in infancy more often have malformations of the urinary tract than girls of the same age, they are at higher risk for urinary tract infections. But already in preschool the relationship changes again.

From the age of 60 to 70 years , the number of affected men increases significantly, so that they are just as common as women with urinary tract infections at this age. Many men develop prostate enlargement (prostate hyperplasia) with older age . You can empty the bladder worse, it remains urine in the bladder (“residual urine”), which in turn favors that a urinary tract infection arises.

Urinary Tract Infection Treatment

An uncomplicated uncomplicated inflammation of the lower urinary tract can be treated well and heals with timely therapy without consequences. But ascending infections of the urinary tract with the involvement of the kidneys usually do not lead to any permanent damage if treated in a timely manner.

How is a urinary tract infection treated?

An uncomplicated inflammation of the lower urinary tract can be treated well and heals with timely therapy without consequences. However, the disease has a tendency to return and may even become chronically recurrent. But ascending infections of the urinary tract with the involvement of the kidneys usually do not lead to any permanent damage if treated in a timely manner.

Urinary Tract Infection Treatment uncomplicated cystitis is usually antibiotic. Although 30-50% of uncomplicated urinary tract infections heal spontaneously and without complications, oral antibiotic therapy is recommended to reduce the unpleasant clinical symptoms more quickly and to completely eliminate the pathogens. After taking antibiotics , the inflammation stops within a few days. About the selection of a suitable antibiotic (Double Shot, 3-day or 7-day therapy) decides the doctor. Supportive or even as a sole therapy with a mild course is also the administration of a painkiller or an antispasmodic drug recommended.

In pregnant women, diabetics , immunosuppressed persons and children, the choice of therapy is adapted to the circumstances.

To the myth “drink a lot” in a urinary tract infection

Since most pathogens adhere to the bladder wall, they can not be “flushed out”. Rather, the body’s defense is greatly diluted by the high fluid intake in the urine and therefore can not develop the full effect. In case of severe pains in the lower abdomen, high drinking volumes lead to relief, as the diluted urine contains less potassium. As a result, the pain fibers of the bladder are not activated as much. So if you have a lot of pain , you should drink a lot, but be aware that the germ repellent then does not work so well.

How much drinking is so “healthy”?

There is a simple rule for the amount of drink: Listen to your body! When are we eating? When we are hungry. So we should drink when we are thirsty. The often-repeated statement “If you are thirsty, then it is already too late” is scientifically complete nonsense. On the contrary, studies have shown even in elite sports that athletes perform better when they drink only when feeling thirsty. 

Because feeling thirsty in the body arises in a healthy person (without brain disease) even with a lack of fluid of 200 ml. If you do not want to trust your own body and absolutely needs numbers to feel safe: 1,500-2,000 ml urine excretion during the day are normal. On some days this is achieved with a drunk liter, others with four liters. It is important that the bladder absorbs a maximum of 450-500 ml, otherwise it will be overstretched and it comes to a disturbance of the bladder muscle function. 

In fact, you can see more and more young women who have overstretched their bladder with excessive drinking, so that they can no longer contract properly. Also this bladder dysfunction, caused by polyuria in polydipsia, is becoming more and more a reason for recurrent urinary tract infections.

Urinary Tract Infection Treatment antibiotics and surgery

In the case of a urinary tract infection, the therapy depends on the type and cause of the infection:

  • If the urinary tract is infected by bacteria and no further risk factors for urinary tract infections are added (so-called uncomplicated urinary tract infection ), an antibiotic is sufficient for the therapy .
  • If there are additionally favoring factors – such as bladder stones , enlargement of the prostate or diabetes mellitus – (so-called complicated urinary tract infection ), in addition to the control of the pathogen usually further steps arenecessary.

If the risk factors are not eliminated, there is a possibility that a chronic urinary tract infection may develop. In a complicated urinary tract infection, the doctor must eliminate as far as possible the favoring factors , such as by means of a surgical procedure.

Type and duration of antibiotic therapy for a urinary tract infection may vary:

  • In case of uncomplicated urinary tract infection, the short-term use of antibioticsusually suffices for therapy  .
  • When a urinary tract infection in pregnancy only antibiotics are used, which do not affect or harm the health and development of the unborn child.
  • In uncomplicated pyelitis (upper urinary tract infection), Urinary Tract Infection Treatment with antibiotics usually extends over a few days . Short-term Urinary Tract Infection Treatment with fosfomycin-trometamol is also possible. Here, a single intake is sufficient.

Treatment of a complicated urinary tract infection

On the other hand, treating a complicated urinary tract infection can sometimes take several weeks. A more severe urinary tract infection with severe pyelitis and severe symptoms such as nausea , vomiting , high fever, and a flu-like malady may also require inpatient Urinary Tract Infection Treatment at the hospital , where patients receive antibiotics by infusion via the vein, often in combination with various medications. Once the urinary tract infection improves, therapy can be continued on an outpatient basis with the help of tablets.

In addition to the causal Urinary Tract Infection Treatment , a symptomatic therapy may be useful: painkillers or antispasmodic drugs help to relieve severe discomfort of a urinary tract infection.

In general, it is important for a successful urinary tract infection to drink plenty of fluids to flush the urinary tract well, even if the urination hurts.

In rare cases, when the kidneys or the prostate are heavily suppurated, surgery for a urinary tract infection for therapy is necessar .

Urinary Tract Infection Treatment without antibiotics

Recurrent urinary tract infections require a high consumption of antibiotics. These help very well, but also weaken the colonization resistance. Phytopharmaceuticals that are not aimed at eradicating the pathogen but at the inflammatory response of the host could provide an effective alternative.

If bacteria are found in the urine during the microbiological examination, this is only a therapeutic indication if clinical symptoms such as dysuria or pollakiuria persist. An asymptomatic bacteriuria should not be treated, stressed Prof. Dr. med. med. Kurt G. Naber, Straubing. 

It has been shown that antibiotic therapy in this case is even unfavorable because it promotes the occurrence of recurrences. This is explained by the fact that the antibiotics eliminate the colonizing, less virulent bacteria that provide protection against ascending infections with virulent bacteria.

With short-term antibiotic therapies, 80-90% of acute uncomplicated cystitis can be healed within a week. As the main pathogen E.coli develops more and more resistance to amoxicillin, oral cephalosporins, cotrimoxazole or fluoroquinolones, the guidelines recommend preferably older oral antibiotics such as fosfomycin-trometamol, nitrofurantoin, pivmecillinam or nitroxoline.

But there are also antibiotic-free herbal alternatives. They are not aimed at germ eradication, but at the host’s inflammatory response, which is ultimately responsible for the symptoms. The pathogens are either eliminated spontaneously or adapt in the sense of an asymptomatic bacteriuria. 

Well documented is the effect of the phytotherapeutic agent CLR (Bionorica), which contains centaury, lovage root and rosemary leaves as active ingredient e. Preclinical studies indicate antiinflammatory and spasmolytic properties of the product.

Direct comparison in study

In an open multicenter pilot study, 125 women with acute uncomplicated urinary tract infection were treated with CLR. The therapy significantly improved symptoms and achieved a cure rate of 71.2% at seven days and 85.6% at 37 days. Only three women (2.4%) still needed antibiotics, because the symptoms persisted under phytotherapy. No woman suffered a recurrence. A prospective Phase 3 study is currently underway comparing the phytotherapeutic agent with a fosfomycin trometamol single-agent therapy.

Diagnosis of a urinary tract infection

To diagnose a suspected urinary tract infection, the doctor will physically examine the patient and take a urine sample : The physician can use urine test strips to detect bacteria, inflammatory cells ( white blood cells or leucocytes) and blood in the urine. Together with the present symptoms, this gives clear indications of an inflammation in the urinary tract .

To determine which pathogens have caused the urinary tract infection, the doctor has a urine culture create. The pathogens from the urine sample are cultivated in the laboratory under suitable environmental conditions. However, if a urinary tract infection develops during pregnancy , after an operation on the urinary tract or after taking  antibiotics , it is not always possible to detect the causative agent.

blood test can also contribute to the diagnosis: In a simple urinary tract infection, the blood levels are unremarkable. In renal inflammation (pyelonephritis), however, the blood levels are changed – there are so-called signs of inflammation :

  • White blood cell count is elevated (leukocytosis) and
  • the blood sediment is accelerated.

In addition, an ultrasound examination (sonography) of the kidneys, ureters, urinary bladder and (in men) of the prostate can be used for a urinary tract infection : In the case of an upper urinary tract infection, some ultrasound-induced changes in the kidneys can be detected. Occasionally the doctor can detect the exact causes (such as kidney stones or bladder stones , anomalies, tumors or prostate enlargements ) during a urinary tract infection by ultrasound. 

A backlog of urine can also be visualized using ultrasound. There is also a special X-ray image to determine if there is a return of urine of the kidneys with contrast (urography).

Typical course

In the case of a urinary tract infection, the course depends mainly on the cause and the right Urinary Tract Infection Treatment : If the urinary tract are infected by bacteria , without otherwise the risk of urinary tract infections is increased (so-called uncomplicated urinary tract infection), the infection may disappear by itself (so-called spontaneous healing ).

urinary tract infection treatment with antibiotics

Usually uncomplicated urinary tract infection heals without consequences in the course of a few days . Although the typical symptoms such as burning on urination , increased urination or pain in the lower abdomen can persist for two to three days, since after the elimination of the pathogens, the inflammatory reactions in the body must first subsided. As a rule, the urinary tract infection is then over.

But if there is a complicated urinary tract infection, more lengthy countermeasures are needed. Without fighting the favorable factors, the infection can take a chronic course .

About every fifth urinary tract infection returns despite therapy (so-called recurrent or recurrent urinary tract infection ). Why this is so often remains unclear.

How to prevent a urinary tract infection

You can prevent a urinary tract infection by following these tips:

  • Drink a lot! Take enough liquid – at least one and a half to two liters per day.
  • Do not comply! In case of urinary urgency, go immediately to the toilet.
  • Empty bladder properly! Adopt a relaxed posture while urinating and do not press hard.
  • Dress warmly! Protect yourself by proper clothing before hypothermia .
  • Generally it is recommended to eat healthy. Put on food that stimulates digestion: Eat lots of fruits, vegetables and fiber!

Against frequent recurrent urinary tract infections by intestinal bacteria such as Escherichia coli , Klebsiella and enterococci is a vaccine available. It contains bacterial components and should support the immune system in combating these pathogens.

Prevention in women:

Women can prevent a urinary tract infection by following these hygiene measures  :

  • when washing the genital area on soaps, intimate wash lotions, etc. dispense, do not use bidet
  • always wipe from front to back after bowel movements, not vice versa
  • Do not engage in unprotected vaginal intercourse immediately after anal intercourse or oral intercourse
  • do not use coated condoms , diaphragms or vaginal suppositories
  • to go to the bathroom as soon as possible after every sexual intercourse

Prevention in men:

Men should clean the foreskin and glans daily (and especially before sexual intercourse) to prevent urinary tract infections. Since a urinary tract infection can also occur during a hospital stay through a urinary catheter, careful hygiene is important here in addition to the correct handling of the catheter.

Urinary Tract Infection Treatment
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