Antibiotics can treat most urinary tract infections (UTIs) successfully. The goals of treatment for UTIs are to relieve symptoms, eliminate the infection and prevent recurrence, and prevent unlikely but serious complications such as kidney damage and sepsis. In pregnant women, treatment protects the woman and the fetus. The number of days your doctor will have you take antibiotics depends on your infection and the type of antibiotic medicine.

Initial treatment

Treatment for uncomplicated bladder infections is usually a combination of antibiotics and home treatment. Home treatment includes drinking a lot of water and fluids and urinating frequently, emptying your bladder each time. More testing is not needed if your symptoms improve.

Oral antibiotics usually can treat kidney infections ( pyelonephritis). But you may need a brief hospital stay and a short course of intravenous (IV) antibiotics if you are too ill or nauseated to take medicine by mouth (oral medicine). Kidney infections tend to make people more severely ill than bladder infections.

You may need more tests before and after treatment if you:

• Are pregnant.
• Are older than 65.
• Have diabetes or an impaired immune system.
• Are a man.

If you have a severe kidney infection, or if a bladder or kidney infection is complicated by other factors, you may need hospital care.

Treatment if the condition gets worse or recurs

If your urinary tract infection (UTI) does not improve after treatment with antibiotics, you will need further evaluation and additional antibiotic treatment.

If the infection spreads and affects your kidney function or causes widespread infection ( sepsis), you will need hospital care. These complications are not common. And they rarely occur in people who are otherwise healthy. People are at higher risk if they have an impaired immune system, diabetes, untreated urinary tract obstruction, and/or other conditions that affect the kidneys or bladder.

A new infection, rather than a relapse of the same infection, usually is the cause of a UTI that keeps coming back (recurs).

• Women with recurrent bladder infections may be treated with preventive antibiotic therapy.
• Recurrent UTIs in men are usually a sign of prostate infection ( prostatitis). Chronic prostatitis can be hard to treat. For more information, see the topic Prostatitis. Follow-up checkups are usually necessary in men who have UTIs and are always necessary if the infection recurs.

What To Think About

Your doctor may base treatment decisions for a bladder infection on your symptoms and urinalysis results, without doing a urine culture. If treatment clears up the symptoms, it confirms the diagnosis of a simple, uncomplicated UTI. If the symptoms do not clear up, you will need further testing to look for:

• A kidney infection.
• Structural problems with the kidneys that increase the risk of infection.
• Infection with an uncommon bacteria.
• An impaired immune system.
• A cause for the symptoms that is not an infection.

If group B streptococcal infection causes a UTI in a pregnant woman, she will receive antibiotic treatment during labor so that she does not pass the infection to her baby. ²

Many forms of bacteria have become resistant to common antibiotics designed to destroy them. These are called antibiotic-resistant bacteria. Antibiotic resistance among bacteria that cause UTIs has increased steadily in recent decades.

You and your doctor may have to try different antibiotics, and different combinations of antibiotics, to find the right medicine that will kill the bacteria causing the UTI. But in most cases, a urine culture and antibiotic sensitivity test will help find the right antibiotic to use.