Treating Symptom-Free UTIs: Everything You Need to Know

You may assume that if there are bacteria in your urine you would experience symptoms, such as a burning sensation on urinating, but this is not necessarily the case. It is possible to have bacteria in your urine along with an absence of symptoms.

We look at treating symptom-free UTIs, who is at risk and who should and shouldn’t be given antibiotics for this condition.  

Table of Contents

What Is a Symptom-Free UTI?

A symptom free urinary tract infection is when there are bacteria present in the patient’s urine, but they have no symptoms of an infection. Typical symptoms of a UTI are burning sensation while urinating, increased urge and frequency of urinating. 

Normal urine is typically sterile in a healthy person so when bacteria are present this will show up in a urinalysis or a urine culture. This condition is called asymptomatic bacteriuria. 

Who Is At Risk Of Symptom-Free UTIs?

Women are more susceptible to asymptomatic bacteriuria, as are those who have abnormalities in their urinary system. However, men, and the elderly can also suffer from this type of symptom free UTI, although the cause may be different in each risk group. 

Women are potentially more likely to be infected by E. Coli while men usually have Gram-negative bacilli and enterococcus species infections. The elderly, particularly nursing home residents, are more often infected with a polymicrobial flora like P. aeruginosa. 

Pregnant women and those suffering from diabetes are also prone to asymptomatic bacteriuria. Those who are sexually active, have a urinary catheter fitted, had recent surgery on the urinary tract or elderly people are other groups susceptible to this condition. 

How Is It Diagnosed?

Your healthcare provider may check your urine for bacteria as part of a routine exam, if you are pregnant or if you are due to have surgery that involves the urinary tract. A urine culture will show whether there are bacteria present in the sample. 

To diagnose asymptomatic bacteriuria there must be a large amount of bacteria on the culture. For diagnosing men only one culture showing bacteria is needed, in the case of women there must be two different cultures showing growth of bacteria. 

Can You Treat Symptom-Free UTIs?

The majority of people with symptom free urinary tract infections will not need treatment. If there are no symptoms then it means that the bacteria is not presenting any harm and no antibiotics should be prescribed. 

Research has shown that treating asymptomatic bacteriuria with antibiotics does not prevent future urinary tract infections. In fact treating the condition can have negative consequences for the patient. 

One reason for not prescribing antibiotics for symptom-free UTIs is that the treatment can lead to drug resistance. So if the patient develops a UTI with symptoms in the future the antibiotic may not clear the infection as the body has developed a resistance to it. 

Giving antibiotics when there are no symptoms of a UTI can create other problems for the patient including a potentially serious kind of diarrhea called C. difficile. 

There are, however, some cases where antibiotics for asymptomatic bacteriuria are recommended. Pregnant women may be offered treatment for a symptomless UTI as there is a risk of low birth weight or premature babies. 

There is a 30-fold increase in pregnant women developing pyelonephritis, inflammation of the kidneys, during their pregnancy if they have asymptomatic bacteriuria. 

Some sufferers of symptom free UTIs are at increased risk of kidney infections. This includes people who have had kidney transplants, those with diabetes and people who have infected kidney stones. 

However, these people should only receive treatment if they develop symptoms of a UTI. In these cases a urine culture will confirm infection and an antibiotic can be prescribed. 

Is It Helpful To Screen For Asymptomatic Bacteriuria?

It is not necessary to screen the vast majority of people for asymptomatic bacteriuria, but there are some risk groups such as pregnant women who would benefit. 

While some people wonder if screening the elderly for symptom-free UTIs would be beneficial, the Infectious Diseases Society of America does not recommend it. 

If someone is due to have surgery for their urinary tract they would likely be screened for asymptomatic bacteriuria and given antibiotics if it is detected. This is to prevent infection or complications setting in after the surgery. 

How Can DrHouse Help You?

DrHouse provides a simple and fast telemedicine service for anyone with concerns about their urinary tract. Our team of clinicans are available 24/7 and you can make on-demand online doctor visits.

Our clinicians can help diagnose any issues you may have, provide personal treatment plans and provide prescriptions if necessary. We can also answer any questions you may have about asymptomatic bacteriuria and its treatment.

So if you have any concerns about your urinary tract health, don’t hesitate to contact us and we’ll be happy to help. 

Final Thoughts

Symptom-free UTIs or asymptomatic bacteriuria is often found in healthy patients, both male and female who have no obvious symptoms. In the majority of cases, treatment with antibiotics is neither necessary nor recommended. 

Only if the patient goes on to develop symptoms of a urinary tract infection should antibiotics be prescribed. The exceptions are pregnant women, recent kidney transplant patients, those with infected kidney stones and people scheduled for urinary tract surgery. 

We hope this guide to treating symptom-free UTIs has been helpful. 

Sources: 

DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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