Medical Treatment

The usual treatment for both simple and complicated urinary tract infections is antibiotics. The type of antibiotic and duration of treatment depend on the circumstances.

Lower urinary tract infection (cystitis)

• In an otherwise healthy young female, a three-day course of antibiotics is usually enough. Some providers prefer a seven-day course to be sure of getting rid of the infection. Occasionally, a single dose of a powerful antibiotic is used.
• Adult males with a UTI require seven to 14 days of antibiotics. If the prostate is also infected (prostatitis), four weeks of antibiotic treatment may be required.
• Adult females with potential for or early involvement of the kidneys, urinary tract abnormalities, or diabetes are usually given a five- to seven-day course of antibiotics.
• Children with uncomplicated cystitis are usually given a 10-day course of antibiotics.
• To alleviate burning pain during urination, phenazopyridine (Pyridium), or a similar drug, can be used for one to two days.

Upper urinary tract infection (pyelonephritis)

• Young, otherwise healthy females with symptoms of pyelonephritis can be treated as outpatients. They may receive IV fluids and antibiotics or an injection of antibiotics, followed by 10-14 days of oral antibiotics. They should follow up with their health care provider in one to two days to monitor improvement.
• If you are very ill, dehydrated, or unable to keep anything in your stomach because of vomiting, an IV will be inserted into your arm. You will be given fluids and antibiotics through the IV until you are well enough to switch to an oral antibiotic.
• A complicated infection may require treatment for several weeks.

You may be hospitalized if you have symptoms of pyelonephritis and any of the following:

• Appear very ill
• Are pregnant
• Have not gotten better with outpatient antibiotic treatment
• Have underlying diseases that compromise the immune system (diabetes is one example) or are taking immunosuppressive medication
• Are unable to keep anything in your stomach because of nausea or vomiting
• Had previous kidney disease, especially pyelonephritis within the last 30 days
• Have a device such as a urinary catheter in place
• Have kidney stones

Urethritis in men and women can be caused by the same bacteria as sexually transmitted diseases (STDs). Therefore, people with symptoms of STDs (vaginal or penile discharge, for example) should be treated with appropriate antibiotics.