Antibiotics are medicines that can kill bacteria. Doctors often use antibiotics to treat urinary tract infections (UTIs). The main symptoms of UTIs are:
However, many people get UTI treatment even though they do not have these symptoms. This can do more harm than good. Here’s why:
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People often have some bacteria in their urine. This does not mean they have a UTI. But doctors may find the bacteria in a routine test and give antibiotics anyway.
The antibiotic does not help these patients:
People without symptoms should not be tested or treated for a UTI unless they are pregnant or about to have some types of surgery – for example, prostate surgery and some procedures to remove kidney stones or bladder tumors.
If you do have a UTI and get treated, you usually don’t need another test to find out if you are cured. You should only get tested or treated if UTI symptoms come back.
Antibiotics can have side effects, such as fever, rash, diarrhoea, nausea, vomiting, headache, tendon ruptures, and nerve damage.
Antibiotics can kill “friendly” bacteria in the body. This can lead to vaginal yeast infections. It can also lead to other infections, severe diarrhoea, hospitalisation, and even death.
Also, antibiotics help drug resistant bacteria grow. These bacteria are harder to kill. They cause illnesses that are harder to cure. Your doctor may have to try several antibiotics. This increases the risk of complications. The resistant bacteria can also be passed on to others. If you get an infection from resistant bacteria, you may need more doctor visits and medicines.
If you have UTI symptoms, antibiotics can help.
The most common UTI symptoms are a painful, burning feeling when you urinate and a strong urge to “go” often.
Other UTI symptoms in older people may include fever, chills, or confusion. Along with these symptoms, there is usually pain on one side of the back below the ribs or discomfort in the lower abdomen. There may be a change in the way the urine looks or smells.
Drink water. Most healthy people should drink 6 to 8 glasses a day. A glass is about a cup or about 250 mL. If you have kidney failure, you should talk to your doctor about how much to drink.
Don’t hold it in. If urine stays in the bladder too long, infections are more likely. Try to urinate when you first feel the need.
Use good hygiene.
Use urinary catheters briefly, if at all.
If you have questions about your symptoms or the medicines managing your symptoms, speak with your health professional.
Developed by Choosing Wisely New Zealand, 2018. Adapted from Choosing Wisely Canada (2013), “Antibiotics for Urinary Tract Infections in Older People”. Choosing Wisely does not assume any responsibility or liability arising from any error or omission or from the use of any information in these resources.
This article is part of our content on Choosing Wisely, a campaign encouraging a change in thinking by health professionals and consumers to avoid unnecessary medical intervention.