UTIs are one of the most common infections in the United States and can affect men as well as women. However, women are more likely to develop urinary tract infections, most of which are treated with antibiotics.
But what happens if the infection doesn’t go away after taking your prescribed medication? We look at four reasons for antibiotic failure to clear UTI symptoms. We will also look at who is susceptible to UTIs and what you can do to relieve the effects of an infection.
Table of Contents
- Why Do UTI Symptoms Persist After Antibiotic Treatment?
- Incorrect Antibiotics
- Infection Is Not A UTI
- Conditions That Mimic UTIs
- Failing To Complete The Antibiotic Course
- Antibiotic Resistance
- Antibiotics Which Are UTI Resistant
- Risks Of Developing A UTI
- Things You Can Do To Relieve UTI Symptoms
- Reducing The Chances Of Developing A UTI
- How Can DrHouse Help You?
- Final Thoughts
Why Do UTI Symptoms Persist After Antibiotic Treatment?
A urinary tract infection is a painful and distressing illness and can affect your life quite severely. Most people will head to the doctor when they have symptoms and more often than not the doctor will prescribe a course of antibiotics to clear up the infection.
But on occasion the symptoms of your UTI may not disappear when you finish your course of antibiotics. So, why is that? What could cause the symptoms to linger when you have taken your prescribed antibiotics?
There are unfortunately a number of reasons why a UTI will persist after treatment. Two reasons are that you are resistant to the antibiotic prescribed, or you have been given the wrong antibiotic for that particular bacterial infection.
It is also possible that the original diagnosis of a UTI infection was wrong. There are other causes of UTI like symptoms and one of these could have mimicked a urinary tract infection.
Another common reason is that people stop taking their antibiotics when the symptoms start to fade and don’t complete the course.
We will take a closer look at each of these reasons to help you understand which, if any, of them apply to you and your situation.
It may be that the reason your UTI did not respond to the antibiotic treatment is because you were prescribed the wrong antibiotic.
To diagnose the presence of a urinary tract infection doctors can use urinalysis which looks at the appearance, chemistry and microscopic aspects of a urine sample. However, unless a urine culture is done the wrong antibiotic may be prescribed.
A urine culture is when bacteria from the urine sample are grown in the laboratory and then tested for sensitivity to antibiotics to identify the best treatment.
A urine culture is the only way to know exactly which type of bacteria, fungus or virus is causing the infection. If this is not done and a generic antibiotic treatment given it is unlikely that it will clear up the infection even if the course of treatment is vigorously followed.
Once the urine culture is grown in a laboratory, the exact strain of bacteria, virus or fungus can be identified. This allows your doctor to be able to target the infection more effectively and prescribe the correct antibiotic treatment.
Infection Is Not A UTI
Antibiotics typically clear up simple urinary tract infections. However, in some cases the UTI can persist after the course of treatment has been completed, even if the regimen is followed diligently.
This may indicate that the problem is not actually a urinary tract infection. There are several conditions that can closely mimic the symptoms of a UTI and this may be why the antibiotics did not work.
If the antibiotics did not clear your symptoms then it is possible that the problem was not a UTI but a condition that presented with similar symptoms.
It is important to go back to your doctor if your course of treatment has failed to improve your symptoms so that you can be checked for other causes.
Conditions That Mimic UTIs
Cystitis is an inflammation of the bladder and a common urinary tract infection. Some forms of this condition can be mild and clear up by themselves, others may need some treatment.
Although a lot of cases of cystitis can be caused by bacteria, it is not the only reason why you may develop this condition.
Other things can irritate the bladder such as spermicide jelly and this type of infection would not be treated with antibiotics, but rather by changing birth control methods.
Acute cystitis is the sudden onset of inflammation and can also be caused by certain medications or long term use of a catheter, neither of which are treated with antibiotics.
Interstitial cystitis is a chronic, or long term, condition involving inflammation of the bladder muscle layers. This creates the symptoms of a urinary tract infection and may be misdiagnosed as such.
An overactive bladder creates a sudden urge to urinate and frequent urination but is not the same as a UTI. Antibiotics have no effect on this condition.
Some types of sexually transmitted infections (STI) can cause similar symptoms to UTIs and may be mistaken for one.
Chlamydia is an STI caused by bacteria and symptoms include a burning sensation when urinating. Antibiotics will usually clear a chlamydia infection.
Gonorrhea is an STI that can present with similar symptoms to a UTI. It is caused by bacteria, so a course of antibiotics should clear it up even if it is misdiagnosed as a UTI.
Trichomoniasis, a sexually transmitted infection, can be mistaken for a UTI but will respond to antibiotics and should clear up if mistaken for a urinary tract infection.
Kidney stones and kidney infections can be mistaken for a UTI. However, kidney infections are often caused by bacteria so in these instances a course of antibiotics should work.
There are four or five types of kidney stones and treatment is tailored to the specific type, but antibiotics do not work on them. Staying hydrated can help prevent the formation of kidney stones as it dilutes the urine and reduces the chances of kidney stones developing.
Water is the preferred way to hydrate yourself as sweet drinks such as sodas and juices can actually increase the risk of kidney stones. Reducing your intake of caffeinated beverages will also help.
Bladder and prostate cancers can present with similar symptoms to a UTI and may be misdiagnosed as such. Obviously, neither of these would respond to a course of antibiotics.
If a type of bladder cancer is present and has been misdiagnosed as a UTI it will not respond to antibiotics. More importantly the symptoms will get worse over time. This is why it is important to speak to your doctor if your UTI hasn’t cleared up after taking antibiotics.
Symptoms such as painful and frequent urination, increased urge to pee, blood in your pee, and urinary incontinence could be signs of bladder cancer. Pain in the abdomen or lower back is also another potential symptom of this more serious condition.
Failing To Complete The Antibiotic Course
Unfortunately one of the most common causes of antibiotic failure to clear UTI symptoms is the patient not fully completing the course or missing doses during treatment.
While the treatment is ongoing the antibiotics are designed to be taken at regular intervals. This is to maintain the level of the prescribed antibiotic in the body in order to give it an opportunity to effectively fight the infection.
By missing a dose or taking it late the level of antibiotic in your system can drop allowing the bacteria to reestablish itself and making it more difficult to get rid of.
This can particularly be the case if the medication has to be taken over 5–7 days as there is more chance of missing a dose.
Another common mistake when taking antibiotics is stopping the medication before the course is finished. When symptoms fade the patient may assume that the infection has cleared up and not take the remaining treatment.
The absence of symptoms can also lead the patient to forget to take the antibiotic. This allows the infection to begin to grow again as there is not enough antibiotics in the patient’s system to kill off all the bacteria.
The resistance to antibiotics is a problem that isn’t just confined to UTI treatment. However, as UTIs are one of the most common infections the issue of antibiotic resistance is widely experienced. This means that the antibiotic does not kill off the infection-causing bacteria.
Who Is Resistant To Antibiotics?
Chronic urinary tract infection sufferers or those who get frequent infections are particularly prone to antibiotic resistance. It is thought that one in five simple UTI or uncomplicated infections may now be resistant to antibiotic treatment.
There are other groups that may have resistance to antibiotics other than chronic or frequent UTI sufferers. Those who are immunocompromised, or who have weakened immune systems. Similarly, those with multiple medical conditions are often resistant to antibiotics.
If you have recently been on an antibiotic regimen this may cause you to be resistant to the antibiotic prescribed for your UTI. Those with recent urinary catheterization are also at risk of developing antibiotic resistance as are the elderly or nursing home residents.
You may wonder why an antibiotic that previously worked to clear your infection now is not effective. This could be that you have developed a resistance to that particular antibiotic from recent or overuse. Or any of the above reasons if they apply to your situation.
Antibiotics Which Are UTI Resistant
Some antibiotics which were once commonly used for the treatment of urinary tract infections are no longer prescribed as they have lost their efficacy against UTIs. This is due to overuse and a growing resistance to them in the general population.
Ampicillin was once commonly prescribed for UTIs but has been abandoned as an effective remedy in favor of drugs such as trimethoprim-sulfamethoxazole, sold as Septra or Bactrim. However, even this is beginning to lose its effectiveness as resistance grows.
Nitrofurantoin, sold as Macrobid is a powerful antibiotic and in most cases, if taken properly will clear a UTI. It is 96% effective against infections of this type which are caused by E. coli.
Risks Of Developing A UTI
If you are unfortunate enough to have suffered from a UTI then you might wonder whether there is anything you can do to reduce the chances of it happening again. Who is at risk of developing a UTI?
Women are 30 times more likely to develop a urinary tract infection than men. There are a couple of reasons for this.
Female anatomy puts the urethra very close to the rectum which means there is a greater risk of bacteria traveling to a woman’s urethra. A female urethra is also much shorter than a male’s, so bacteria can more easily access the bladder.
Cleaning from front to back after using the toilet is good advice for women and reduces the risk of bacteria getting into the urethra and causing a UTI. This simple but effective practice can reduce the number of UTIs women get.
Those who have frequent sex, or have a medical condition such as diabetes are also at increased risk of developing a UTI. As mentioned, using a spermicide can also increase your risk and those who have had a UTI in the past year are more likely to develop an infection.
Things You Can Do To Relieve UTI Symptoms
There are things you can do to relieve the symptoms of a UTI if antibiotics haven’t cleared it up straight away. You will likely need another course of treatment or a stronger antibiotic, but there are things you can do to reduce the symptoms while you wait for the treatment to work.
Drinking more water is highly recommended as it makes you pee more often and this can flush out bacteria from your bladder and urethra. Cranberry juice has long been recommended as a potential UTI treatment and may work for some people.
Reducing The Chances Of Developing A UTI
Lifestyle changes can make a big difference to the frequency and severity of a UTI.
Get in the habit of wiping yourself from front to back after using the bathroom. Also do not hold your urine or delay going to the bathroom, go as soon as you have the urge.
Peeing after sex is a good way to help you prevent UTIs after sex, as it will flush out any bacteria before it has a chance to cause a problem for you.
Eating more fruits and vegetables which contain high amounts of vitamins and minerals will support your immune system. This can help prevent further UTIs if used in conjunction with a good hygiene routine. Vitamin C is particularly good at lowering the chances of an infection.
Taking a probiotic may also reduce the risk of developing a UTI. It will also help to replace the good bacteria in your body following a course of antibiotics.
A cranberry or garlic supplement is also worth trying as a way of reducing the frequency and severity of a UTI, although these are not scientifically proven remedies.
How Can DrHouse Help You?
DrHouse is here to help if you are suffering from symptoms of a UTI and need advice or treatment. Our online doctors can diagnose and treat a urinary tract infection quickly and safely.
DrHouse provides a 24/7 telehealth service where you can see a licensed clinician within minutes from the comfort of your home or office and get an accurate diagnosis and treatment plan.
We can provide advice on lifestyle changes that may help reduce the risk of further UTIs and can provide prescriptions for antibiotics should you need them.
We understand how uncomfortable and painful a UTI can be, and we are here to help you get back to feeling your best as quickly as possible.
UTIs are an unfortunate and painful fact of life for many men and women. While antibiotics
work for a lot of people, they do not always clear the symptoms for everyone.
We hope that this guide has helped you and given you some insight into why antibiotics may not clear up a UTI infection.
- Urinary Tract Infections. Centers for Disease Control and Prevention (CDC). Available from: https://www.cdc.gov/antibiotic-use/uti.html
- Foxman, B. The epidemiology of urinary tract infection. Nat Rev Urol 7, 653–660 (2010). https://doi.org/10.1038/nrurol.2010.190
- Urinary tract infection (UTI). Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453
- Antibiotic resistance. World Health Organization (WHO). Avialable from: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
- About Antimicrobial Resistance. Centers for Disease Control and Prevention (CDC). Available from: https://www.cdc.gov/drugresistance/about.html
- Jancel T, Dudas V. Management of uncomplicated urinary tract infections. West J Med. 2002 Jan;176(1):51-5. doi: 10.1136/ewjm.176.1.51. PMID: 11788540; PMCID: PMC1071654.
- Schooff M, Hill K. Antibiotics for recurrent urinary tract infections. Am Fam Physician. 2005 Apr 1;71(7):1301-2. PMID: 15832532
- Jill S. Huppert, Frank Biro, Dongmei Lan, Joel E. Mortensen, Jennifer Reed, Gail B. Slap. Urinary Symptoms in Adolescent Females: STI or UTI? Journal of Adolescent Health. Volume 40, Issue 5. 2007. Pages 418-424. ISSN 1054-139X. Available from: https://doi.org/10.1016/j.jadohealth.2006.12.010
- Storme O, Tirán Saucedo J, Garcia-Mora A, Dehesa-Dávila M, Naber KG. Risk factors and predisposing conditions for urinary tract infection. Therapeutic Advances in Urology. 2019;11. doi:10.1177/1756287218814382