Best Treatment to UTI with and without Antibiotics

Reference Based Article

Treatment to UTI is easy now a days compared to 3 or 4 decades before. Now a days better molecules of antibiotics are available to treat UTI. Similarly more information is available for patients online to treat mild UTIs without antibiotics.

What is UTI?

UTI (Urinary Tract Infection) is basically bacterial infection in the urinary tract from where urine is passed through. Gram Negative bacteria are responsible for such infections in urinary tract. Between 65% and 90% of urinary tract infections (UTIs) in children are caused by Escherichia coli. Other pathogens include Klebsiella species, Proteus species, Pseudomonas aeruginosa, and Enterococcus species.1


UTIs occur more often in women than in men, at a ratio of 8:1. Approximately 50–60% of women report at least one UTI in their lifetime, and one in three will have at least one symptomatic UTI necessitating antibiotic treatment by age 24 years.2

Simple and Complex UTIs

Treatment to UTI is sometimes very simple; while sometimes complex— when there is antibiotic resistance developed.

Simple UTIs may contain pathogens that are sensitive to first line antibiotics and the conditions of simple UTIs are usually mild to moderate. While complex UTIs may not be sensitive to first line antibiotics and or conditions may also more worse than simple UITs.

It is very easy to treat simple UTIs while complex UTIs are somewhat difficult to treat.

For complex UTIs sensitivity analysis is necessary to investigate the pathogens and their sensitivity with antibiotics before going to start any antibiotic.

What is Antibiotic Resistance?

Resistance of microorganisms against the antibiotics developed due to mis use of antibiotics. After the Antibiotics Resistance developed, Antibiotics fail to stop growth or kill microorganisms because microorganisms develop immunity against those antibiotics. For antibiotic resistant patients, either higher doses of antibiotics are required or other alternatives (next line antibiotics) are given.

In case of antibiotic resistance treatment to UTI becomes complex.

Which Antibiotic is best?

The simple answer to this question is; it depends on your history of taking antibiotics (To which antibiotics you are resistant– comes from culture sensitivity analysis) and the UTI condition (mild, moderate or severe). Thus moving from first line to second line and then to third line antibiotics is a good strategy to treat UTI.

A- Treatment to UTI with Antibiotics

1- Treatment to Simple UTIs

Nitrofurantoin, Fosfomycin, Sulfamethoxazole-Trimethoprim are first line treatment to UTI.

Amoxicilline-Clavulanic Acid (Augmentin) and some Cephalosporins for example Cefpodoxime, Cefaclor or Cefdinir may be appropriate options when first-line options cannot be used.

Treatment length of Cystitis may range from once daily dose to the length of 5 to 7 days.

2- Treatment to Complicated UTIs

FDA safety recommendation says, doctors should not advise Fluoroquinolone for simple UTIs. Fluoroquinolone group contains Moxifloxacin, Ciprofloxacin, Levofloxacin, Ofloxacin and Gemifloxacin. This group is only to treat complicated UTIs when there is no option available to treat UTI.

For Painful UTI use Phenazopyridine

For painful UTIs phenazopyridine is recommended to take along with antibiotics. It acts as local analgesic effect when excreted in urine. Take this medicine 3 times daily after meal or with the consultation of your doctor. Don’t take it for more than 2 days.

B- Treatment to UTI without Antibiotics

Sometimes UTI can be managed without antibiotics. So for this purpose here are some ways you can treat to UTI at home without antibiotics. Sometimes doctor may advise following tips along with antibiotics course to get speedy healing UTI. Here are 15 ways of treatment to UTI without antibiotics.

1- Drink Plenty of Water

First of all you must drink plenty of water so that urine passage is flooded with more water than in routine. This would help in flushing out bacteria present in the infection point in urinary tract.

A study on “Hydration monitoring in the prevention of recurrent idiopathic urinary tract infections in pre-menopausal women” showed the use of the osmolality probe encouraged the subject to maintain adequate hydration. The resulting augmentation of the natural urethral ‘washout’ mechanism led to lower osmolality urine and a reduction in the incidence of UTIs.3

In a study it was exhibited that low urine output was major reason to develop UTI.4

In another study of 141 girls aged 3.9 to 18 years, poor fluid intake was one of the behavioural abnormalities that was responsible to cause UTI.5

2- Increase Vitamin-C Use

A study of 110 pregnant women revealed that after 3 months, the presence of urinary tract infections in the Vitamin C treated group was significantly lower.6

Laboratory findings, about the role of vitamin C to decrease UTI, exhibit Vitamin C has bacteriostatic effect in urine.7

It is considered Vitamin C kills bacteria because of acidic nature.

In another study of women using University of Michigan Health Service, Vitamin C appeared to protect against UTI.8

3- Don’t Hold Urine

Chances of UTI increased when you hold urine too long. Urinate when the need arises because it gives bacterias more time to cause infection.9

Moreover it develops pressure on bladder and valve which if persists in longer run, may cause failure of valve.

4- Drink Cranberry Juice/Tablets

Cranberry juice is effective to reduce urinary infection. For those patients interested in taking cranberry prophylaxis, cranberry tablets have been shown to be twice as cost effective as cranberry juice.10

In vitro and ex vivo research has confirmed that proanthocyanidin, a chemical found in high concentration in cranberry, has a dose-dependent effect on E coli adherence to and displacement from urothelial cells.11 It means higher the cranberry juice you intake higher is the chances of detachment of bacteria from urinary tract.

5- Take D-mannose sugar

A pilot study was conducted in Department of Gynaecological Obstetrics and Urologic Sciences of “Sapienza” University of Rome to check D-mannose sugar efficacy in UTIs. The results of this study suggest that D-mannose can be an effective aid in acute cystitis (acute UTI) management and also a successful prophylactic agent in a selected population.12

6- Use Garlic

Garlic contains powerful compounds that kill bacteria. A study on “Antibacterial activity of garlic extract on streptomycin-resistant Staphylococcus aureus and Escherichia coli solely and in synergism with streptomycin” shows the garlic paste has significant impact on inhibition of bacterial growth.13

So the garlic paste can be used with food or you can dink its diluted juice. For diluted juice, peel a couple of fresh garlic cloves, crush them well, then drop them into warm water and let them steep for 5 minutes before drinking.

7- Avoid Bath / Take Shower

Taking bath may cause more risk of having UTI especially for those who has recurrent UTI history. It is because of two reasons.

One, water may contain bacteria which can easily enter the urinary tract due to longer in contact and can cause infection.

Second, due to moisture, skin becomes vulnerable to adopt bacterial colony in urethral openings so bacteria can grow easily and cause UTI.

8- Prevent from Irritants 

Prevent from Irritants such as alcohol, soft drinks, coffee and like that. Because all these causes irritation during urination which may further aggravate the UTI to painful UTI or painful UTI to more painful UTI.

9- Take Probiotics

Probiotics are beneficial microorganisms that could protect against UTIs. Lactobacilli strains are the best-known probiotics and are found in fermented milk products, mainly yogurt. Other probiotics include Lactobacilli bifidobacteriarhamnosuscaseiplanetariumbulgaricus and salivarius; Streptococcus thermophiles and Enterococcus faecium.14

At the end of 10 weeks, women in the L crispatusCTV-05 arm were found to have a significant reduction in the incidence of UTI when compared with the placebo-treated group 15

10- Hygienic Sexual Habits

Wipe and wash well before and after sex. Unhygienic conditions may cause UTI more easily. Because there are more chances, bacteria can enter urethral openings of both male and female.

Urinate before and after sex that also helps reduce urinary tract infection. Always urinating before or after intercourse tend to protect against UTI.16

11- Good Washing Practice

Trick to avoid urinary tract infection is wash and wipe from front to back after defecation especially for females. Wiping from back to front can facilitate bacteria to enter in urethra from anus.

So wipe your butt from front to back to prevent bacteria from reaching the urethra from around the anus.

Also practice good washing of all the area around anus so that bacteria must be flushed out with water.

12- Cotton Underwear and Loose fitting Clothes

Moisture can cause to grow bacteria and form colonies while dry area don’t facilitate bacteria to grow. So wearing cotton underwear and loose-fitting clothes allows air to pass and keep the area dry. Avoid tight fitting clothes and nylon underwear, which trap moisture and can help bacteria grow.

13- Avoid bike riding

If you are suffering from UTI or susceptible to recurrent UTI then avoid bike riding. It may cause or aggravate the UTI because of several reasons.

Urethral opening remain in contact with pressure of weight so rubbing effect may cause inflammation. Moreover there is no way for air to pass through easily to keep the surface dry. Sweating sometimes play an important role in getting UTI.

So it is better to avoid bike riding to treat UTI without antibiotics. Because there are more chances of healing when the surface remains dry.

14- Appropriate use of Urinary Catheters

If some is using Urinary Catheters especially for nurses or doctors, it must be placed appropriately and checked to avoid developing UTI. A study shows appropriate use of urinary catheter reduced the risk of UTI. Catheter blockage was the only indicator to UTI.17

Make sure leaking and blockage must not happen and Urinary Catheters are appropriately placed.

15- Avoid Spermicide-Coated Condoms

In a study of 1299 women, Spermicide-coated condoms were associated with an increase risk of UTI caused by S saprophyticus.18 So avoid spermicide-coated condoms to avoid UTI.


Dilshad Zaman

Doctor of Pharmacy and Master in Business Administration. He loves to write articles on various topics.

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