Urinary tract infection (UTI)

In the future, scientists may develop a vaccine that can prevent UTIs from coming back.

Researchers in different studies have found that children and women who tend to get UTIs repeatedly are likely to lack proteins called immunoglobulins, which fight infection.

Children and women who do not get UTIs are more likely to have normal levels of immunoglobulins in their genital and urinary tracts.

UTIs in men are often a result of an obstruction—for example, a urinary stone or enlarged prostate—or from a medical procedure involving a catheter.

The first step is to identify the infecting organism and the drugs to which it is sensitive.

Usually, doctors recommend lengthier therapy in men than in women, in part to prevent infections of the prostate gland.

Prostate infections (chronic bacterial prostatitis) are harder to cure because antibiotics are unable to penetrate infected prostate tissue effectively. For this reason, men with prostatitis often need long-term treatment with a carefully selected antibiotic.

Women who have had three UTIs are likely to continue having them. Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. A woman who has frequent recurrences (three or more a year) can ask her doctor about one of the following treatment options:

• Take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. If taken at bedtime, the drug remains in the bladder longer and may be more effective. NIH-supported research at the University of Washington has shown this therapy to be effective without causing serious side effects.

A pregnant woman who develops a UTI should be treated promptly to avoid premature delivery of her baby and other risks such as high blood pressure.

Some antibiotics are not safe to take during pregnancy.

In selecting the best treatments, doctors consider various factors such as:

• the drug's effectiveness,
• the stage of pregnancy,
• the mother's health, and

UTIs are treated with antibacterial drugs. The choice of drug and length of treatment depend on the patient's history and the urine tests that identify the offending bacteria. The sensitivity test is especially useful in helping the doctor select the most effective drug. The drugs most often used to treat routine, uncomplicated UTIs are trimethoprim (Trimpex), trimethoprim/sulfamethoxazole (Bactrim, Septra, Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and ampicillin (Omnipen, Polycillin, Principen, Totacillin). A class of drugs called quinolones includes four drugs approved in recent years for treating UTI. These drugs include ofloxacin (Floxin), norfloxacin (Noroxin), ciprofloxacin (Cipro), and trovafloxin (Trovan).

Cranberry juice has been used for ages as a prevention or even a treatment for urinary tract infections. Most think that its effectiveness resides in increasing the acidic environment of the bladder and making it more hostile to bacterial growth. Recently, there has been some thought that it affects E. coli's ability to adhere to the urethra (tube which leads from the bladder to the outside). E. coli is found in all of our intestines. Women are more predisposed to urinary tract infections due to their shorter urethra and shortened length between the anus and the urethra.