TREATING YOUR INFECTION – URINARY TRACT INFECTION (UTI) For women under 65 years with suspected lower urinary tract infections (UTIs) or lower recurrent UTIs (cystitis or urethritis)

Possible urinary signs & symptoms The outcome Recommended care Types of urinary tract infection (UTI)

Key signs/symptoms: All women: Self-care and pain relief. UTIs are caused by bacteria getting into your urethra Dysuria: Burning pain when passing urine (wee) If none or only one of: dysuria, • Symptoms may get better on their own. or bladder, usually from your gut. Infections may occur New nocturia: Needing to pass urine in the night new nocturia, cloudy urine; Delayed or backup prescription with in different parts of the urinary tract. Cloudy urine: Visible cloudy colour when passing urine AND/OR vaginal discharge self-care and pain relief. Kidneys (make urine) Other severe signs/symptoms: • Antibiotics less likely to help. Start antibiotics if symptoms: Infection in the upper urinary tract Frequency: Passing urine more often than usual • Usually lasts 5 to 7 days. • Get worse. • Pyelonephritis (pie-lo-nef-right-is). Urgency: Feeling the need to pass urine immediately • You may need a urine test to check • Do not get a little better with Not covered in this leaflet and Haematuria: Blood in your urine for a UTI. self-care within 48 hours. always needs antibiotics. Suprapubic pain: Pain in your lower tummy Non-pregnant women: Immediate antibiotics prescription Bladder (stores urine) Other things to consider: If 2 or more of: dysuria, new nocturia, plus self-care. Infection in the lower urinary tract Recent sexual history cloudy urine; OR bacteria detected • Cystitis (sis-tight-is). • Inflammation due to sexual activity can feel in urine; AND NO vaginal discharge If mild symptoms, delayed or similar to the symptoms of a UTI. • Antibiotics are more likely to help. back-up antibiotic prescription Urethra (takes urine • Some sexually transmitted infections (STIs) can • You should start to improve within 48 hours plus self-care. out of the body) have symptoms similar to those of a UTI. • Symptoms usually last 3 days. Infection or inflammation Changes during menopause Pregnant women: Always request urine culture in the urethra • Some changes during the menopause can have • Urethritis (your-ith-right-is). symptoms similar to those of a UTI. If suspected UTI. Immediate antibiotic prescription.

When should you get help? Self-care to help yourself Options to help prevent a UTI Antibiotic resistance get better more quickly Contact your GP practice or NHS 111 • Drink enough fluids to stop The following symptoms are possible It may help you to consider these risk factors: Antibiotics can be lifesaving. But antibiotics are not you feeling thirsty. Aim to signs of serious infection and should be always needed for urinary symptoms. drink 6 to 8 glasses including assessed urgently. Stop bacteria spreading from your bowel into your bladder. water, decaffeinated and Wipe from front (vagina) to back (bottom) after using the toilet. Phone for advice if you are not sure how Antibiotics taken by mouth, for any reason, affect our sugar-free drinks. Avoid waiting to pass urine. Pass urine as a soon as you urgent the symptoms are. need a wee. gut bacteria making some resistant. • Take paracetamol or ibuprofen 1. You have shivering, chills and Go for a wee after having sex to flush out any bacteria that at regular intervals for pain relief, muscle pain. may be near the opening to the urethra. Antibiotic resistance means that the antibiotics if you have had no previous 2. You feel confused, or are very drowsy. cannot kill that bacteria. side effects. Wash the external vagina area with water before and after 3. You have not passed urine all day. sex to wash away any bacteria that may be near the Antibiotic resistant bacteria can remain in your gut for • You could try taking cranberry 4. You are vomiting. opening to the urethra. at least a year after taking an antibiotic. capsules or cystitis sachets. 5. You see blood in your urine. Drink enough fluids to make sure you wee regularly These are effective for some 6. Your temperature is above 38oC throughout the day, especially during hot weather. Common side effects to taking antibiotics include women. There is currently no or less than 36oC. If you have a recurrent UTI, also consider the following: thrush, rashes, vomiting and diarrhoea. Seek medical evidence to support their use. 7. You have kidney pain in your back • Cranberry products and D-mannose: Some women advice if you are worried. • Consider the risk factors in the just under the ribs. find these effective, but there is currently poor evidence to ‘Options to help prevent UTI’ 8. Your symptoms get worse. support this. Keep antibiotics working, only take them when column to reduce future UTIs. 9. Your symptoms are not starting to • After the menopause: You could consider topical hormonal advised by a health professional. This way they are more improve within 48 hours of likely to work for a future UTI. taking antibiotics. treatment, for example, vaginal creams. Developed in collaboration with professional medical bodies. © Crown copyright 2018. 20 October 2021. KAW18-07 Version

Keep Antibiotics Working