Urinary tract infection

Alternative Names

Treatment

A mild case of cystitis may go away on its own without treatment. Because of the risk of the infection spreading to the kidneys, however, antibiotics are usually recommended. It is important that you finish the entire course of prescribed antibiotics.

In children, cystitis should be treated promptly with antibiotics to protect their developing kidneys. In the elderly, prompt treatment is recommended due to the greater chances of deadly complications.

Commonly used antibiotics include:

• Amoxicillin
• Doxycycline (should not be used under age 8)
• Cephalosporins
• Nitrofurantoin
• Sulfa drugs (sulfonamides)
• Trimethoprim-sulfamethoxazole
• Quinolones (should not be used in children)

Most non-elderly adult women only need 3 days of antibiotics. If the infection has spread to one of the kidneys, you may need to be admitted to a hospital so you can receive fluids and antibiotics through a vein.

A chronic or recurrent UTI should be treated thoroughly because of the chance of kidney infection. Antibiotics may need to be given for a long period of time (as long as 6 months to 2 years), or stronger antibiotics may be needed than for single, uncomplicated episodes of cystitis.

Phenazopyridine hydrochloride (Pyridium) may be used to reduce the burning and urgency associated with cystitis. In addition, acidifying medications such a ascorbic acid may be recommended to decrease the concentration of bacteria in the urine.

If an anatomical abnormality is present, surgery to correct the problem may be recommended.

Outlook (Prognosis)

Cystitis is uncomfortable, but usually responds well to treatment.

Possible Complications

• Chronic or recurrent urinary tract infection -- defined as at least two infections in 6 months or at least three in 1 year
• Complicated UTI
• Kidney infection

When to Contact a Medical Professional

Call your doctor if you, or your child, have symptoms of a UTI. Call right away if there is fever or chills, back or side pain, or vomiting. These symptoms suggest a possible kidney infection.

Also call if:

• You have diabetes or are pregnant
• There is discharge from the penis or vagina
• The penis or vagina is painful, or sexual intercourse is painful
• You suspect a child may have been sexually abused
• There is blood or pus in the urine
• The symptoms come back a short time after treatment with antibiotics

References

Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for medical management of first urinary tract infection in children 12 years of age or less. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2006 Nov. 23 p.

Walsh, PC, ed. Campbell’s Urology. 8th ed. Philadelphia, Pa: Saunders; 2002.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.