Urinary tract infections (UTIs)

Most UTIs are caused by bacteria which normally live harmlessly in the bowel. If these bacteria spread from the anus to the urethra and up into the urinary system they can cause:

• urethritis – infection in the urethra
• cystitis – infection in the bladder
• pyelonephritis – infection in the kidneys.

Most UTIs are not contagious and cannot be passed from person to person. However, some types of urethritis can be caused by sexually transmitted infections (e.g. chlamydia and gonorrhoea).

Sexually transmitted infections (STIs) often cause infections of the urethra and symptoms similar to a UTI. It’s extra important for people with UTI symptoms to ask their doctor for a test for chlamydia and gonorrhea, as well as a UTI test, if they are aged under 40 years or have recently changed sexual partners.

Symptoms of UTIs can be mild or severe. Common symptoms of a UTI include:

• a prickly, stinging or burning feeling when passing urine
• needing to urinate a lot.
• a feeling that the bladder is still full after urinating
• a constant, dull ache in the lower belly.
• cloudy, bloody or strong-smelling urine.

A person with a kidney infection (pyelonephritis) can also experience:

• Fever and/or chills
• Nausea and/or vomiting
• Back pain

A child with a UTI may also experience:

• Irritability
• Day or night wetting in a child who has been toilet trained
• Feeding problems in babies
• Vomiting
• Lethargy
• Fever

An older adult with a UTI may also experience:

• Confusion
• Changes in behaviour
• Fever

Diagnosis of a UTI may be based on your symptoms.

If you are concerned that you may have a UTI, you should be assessed by a pharmacist or a doctor.

Women aged 18 to 65 years with an uncomplicated UTI may be able to be assessed and treated by a pharmacist. All other persons, including women with recurrent UTIs, should be assessed by a doctor.

Children should always be seen by a doctor if a UTI is suspected. UTIs can be very serious in the first few years of life and may need urgent treatment.

UTIs in men, pregnant women, and older adults are also more complicated and should be assessed by a doctor.

A kidney infection is serious and needs urgent treatment by a doctor

A urine test (urine dipstick) may be used provide evidence to support the diagnosis of a UTI. A urine sample taken by your doctor may be sent to a laboratory to identify the specific cause of the infection and to help determine the correct antibiotic for treatment.

• Women – tend to get UTIs because the female urethra is short and close to the anus. Sexually active females have a higher risk because sex can push bacteria into the urethra. UTIs can also be the result of hormone changes such as the menstrual cycle, pregnancy and menopause.
• People with a urinary catheter – a catheter is a tube put into the bladder to drain urine (e.g. after surgery).
• People with a blockage or defect in their urinary system.
• Elderly people – especially if they have bladder or bowel problems.
• People with diabetes – can have changes in their bladder, urine and immune system that lead to recurrent UTIs.
• People with a weakened immune system.
• Babies and young children – especially those born with a defect in their urinary system.

Ask your pharmacist or doctor for advice. The following treatment options are available.

Symptom relief

• Urinary alkalinisers (e.g. Ural, Citravescent) make urine less acidic. This may reduce the stinging or burning feeling caused by passing urine. These may not be suitable with some antibiotics so it is important to check with your doctor or pharmacist.
• Simple pain relievers (e.g. paracetamol, ibuprofen) can reduce pain and discomfort.

Antibiotics

UTIs usually need to be treated with prescription antibiotics. Your doctor or in some cases your pharmacist can prescribe antibiotic to treat your UTI.

• Take prescribed antibiotics as directed by your doctor or pharmacist. It is important to finish the course of antibiotics and not stop early if UTI symptoms improve or resolve.
• UTI symptoms often improve within two days of starting treatment with an antibiotic.
• If your symptoms are not improving within 2 days you need to be reviewed by your doctor

Self-care

Actions that can help to clear cystitis include:

• drink plenty of water to keep hydrated while flushing the bacteria out of the urinary tract
• empty your bladder completely when urinating.

Actions that may reduce the risk of getting UTIs include:

• drink enough water every day to satisfy your thirst and to keep your urine ‘light-coloured’ (unless a doctor advises you not to)
• urinate when you feel the urge, rather than holding on
• empty your bladder completely when urinating

For women:

• wipe from front to back (urethra to anus) after passing urine or emptying your bowels
• empty your bladder soon after sex

People who experience frequent UTIs may benefit from treatment that aims to prevent future infections. Ask your doctor or pharmacist for advice.