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Cut Urinary Tract Infection Risks

Antibiotic-resistant bacteria are behind many recurrent UTIs. What can a woman do to reduce risks?

Antibiotic Resistance: Why Your UTI Risks Are Rising continued...

Urinary tract infections can affect all of the organs in the urinary system: the urethra, bladder, ureters, or kidneys. About 85% of UTIs in women are caused by bacteria, such as E. coli, Stamm says. In women, E. coli can spread to the urethra from the vagina or intestines.

In most cases, antibiotic treatment is effective against urinary tract infections, Stamm says. But not always.

According to one recent study published in the International Journal of Antimicrobial Agents, many drugs are no longer a sure bet against UTI-causing E. coli. Scientists from the University of Manitoba gathered urine samples from patients, mostly women, at 41 U.S. and Canadian hospitals. Ampicillin, one drug that's no longer commonly used, had a resistance rate of nearly 38%.

Particularly worrisome: a more than 21% resistance rate to the antibiotic trimethoprim-sulfamethoxazole.

Trimethoprim-sulfamethoxazole "has been the workhorse for treating uncomplicated urinary tract infections for many years," says Stamm. It's disturbing to see resistance rates rise so high in some communities, he says. "When resistance gets up to 20%, you consider another antibiotic."

Fortunately, doctors have been able to prescribe an alternative group of antibiotics called fluoroquinolones. Yet now they're starting to see resistance in some fluoroquinolones, too. For example, the Manitoba researchers found that ciproflaxin (Cipro), had a 5.5% resistance rate, and levofloxacin (Levaquin), a little over 5%.

With recurrent urinary tract infections, urine analysis and testing becomes crucial for effective treatment. "Urine cultures are usually indicated in managing women with recurrent UTI," Stamm says. "It's useful to determine the susceptibility to antibiotics since these women often have more resistant strains."

If women don't take the full course of antibiotics as prescribed -- perhaps because they start to feel better -- the infection may return. Stopping the drug too soon also encourages development of resistant bacteria.

Preventing Recurrent Urinary Tract Infections

Women with recurrent UTIs can cut their risk with a few practical tips:

  • Drink more liquids, especially water, to help flush out bacteria.
  • Drink unsweetened cranberry juice daily.
  • Urinate more often.
  • Empty your bladder shortly after sex.
  • After urination or a bowel movement, wipe from front to back.
  • Avoid spermicide use with a diaphragm; spermicides increase risk of urinary tract infections.
  • Take showers instead of baths.
  • Avoid feminine hygiene sprays, douches, and powders.

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