Patient information · Urgent care
Urinary tract infection
cystitis, antibiotics, and when it is more than a bladder infection
A urinary tract infection is bacteria growing in the bladder or urethra. It is common in women, uncomfortable rather than dangerous in most cases, and often settles by itself. What matters is recognising the point at which it stops being a bladder infection and starts involving the kidneys.
Seek medical help the same day if you have
- pain in your back or side, below the ribs — this suggests the kidney is involved;
- a temperature, shivering or shaking chills;
- nausea or vomiting alongside urinary symptoms;
- blood in your urine;
- confusion, drowsiness or agitation — in an older person this may be the only sign of infection;
- symptoms that are not improving after 48 hours on antibiotics, or are getting worse.
A kidney infection needs treating promptly and with a different, longer course of antibiotics. Call 999 or go to an emergency department if you feel very unwell, are breathing fast, have a rapid heartbeat, mottled skin, or have not passed urine all day. The nearest emergency department is the Royal London Hospital, Whitechapel Road, London E1 1FR.
Typical symptoms
- burning, stinging or pain when passing urine;
- needing to go far more often, and urgently;
- passing only small amounts, and feeling you have not finished;
- cloudy, dark or strong-smelling urine;
- a dull ache low in the abdomen or the lower back;
- generally feeling below par.
Some people should always be assessed rather than self-treating
Anyone who is pregnant; men with urinary symptoms; children; anyone with a catheter, a weakened immune system, kidney disease, diabetes, or recurrent infections. In these groups a UTI is managed differently and needs proper assessment. Contact us the same day.
Self-care for a mild infection
Around half of straightforward bladder infections in otherwise healthy women settle without antibiotics within a few days. It is reasonable to try self-care for 48 hours if you are not unwell in yourself and have none of the warning signs above.
- Drink enough that your urine is pale — you do not need to force litres, just keep steadily hydrated.
- Paracetamol or ibuprofen at the dose on the packet for the pain and any temperature.
- Do not hold on. Pass urine as soon as you feel the need, and try to empty the bladder fully each time.
- A hot water bottle against the lower abdomen or back can help the ache.
- Avoid sex until symptoms have gone.
What about cranberry and urine alkalinisers?
Cranberry juice and capsules do not treat an infection you already have. There is some limited evidence that cranberry products may slightly reduce how often recurrent infections happen in some women, but it is not strong, and cranberry can interact with warfarin.
Sachets and tablets that alkalinise urine may ease stinging for some people, but they are not a treatment and are not suitable if you have heart or kidney problems, or are on a low-sodium diet.
Antibiotics
- For a straightforward bladder infection in a woman, a three-day course is usually enough. Men, pregnant women and more complicated infections need longer.
- Symptoms typically improve within 48 hours of starting. Finish the course even once you feel better.
- Tell us about any antibiotic allergy before you start, and about other medicines you take.
- Contact us if you are no better after two days, if symptoms return quickly after finishing, or if you develop diarrhoea, a rash or any other reaction.
- A urine sample may be sent to the laboratory to identify the bacteria and confirm the antibiotic is the right one. This is routine, and we will contact you if the result means a change is needed.
Reducing the chance of it coming back
- Drink enough fluid through the day rather than in large amounts occasionally.
- Do not delay passing urine, and empty the bladder fully — do not rush.
- Pass urine shortly after sex.
- Wipe from front to back.
- Avoid perfumed soaps, bubble baths, douches and feminine hygiene sprays. Wash with water or an unperfumed emollient.
- Consider whether a spermicide-containing contraceptive or a diaphragm is contributing — we can discuss alternatives.
- After the menopause, vaginal dryness makes infections more likely, and topical vaginal oestrogen substantially reduces recurrence for many women. It is worth asking about.
Three or more infections in a year? That is worth investigating rather than treating each episode as a one-off. We can arrange urine cultures, an ultrasound of the urinary tract, and a review with our GP or urology team, and discuss options such as preventive antibiotics, a self-start supply for early treatment, or vaginal oestrogen.
Same-day assessment, on-site urine testing
Seen and treated in one visit, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk. Your local pharmacist can also help.