Recurrent Urinary Tract Infections

A urinary tract infection (UTI) is an infection involving the bladder and the urethra. While sometimes UTIs can go unrecognized and the body can clear them without medications, recurrent urinary tract infections are defined as occurring more than once in a 6-month period, or more than twice per year.

It is important to have a specialist manage recurrent UTIs to help avoid kidney infections and prevent permanent kidney damage. The experienced team at The University of Kansas Health System offers advanced treatment options for even the most stubborn recurrent UTI symptoms.

Recurrent urinary tract infections are diagnosed when a person gets 3 or more UTIs in a 1-year period. In some cases, these infections can be resistant to treatment, so it’s important to accurately identify the type of bacteria responsible for causing the infection. This allows your doctor to prescribe the most effective antibiotic for your particular type of urinary tract infection.

Common signs of UTIs include:

• Burning with urination
• Chills
• Fever
• Flank pain (pain near the middle and lower back)
• Foul-smelling urine
• Nausea
• New or worsening frequent urination

If urinary tract infections are not treated, they could in some situations lead to infections involving the kidneys. Signs of kidney infections include flank pain (pain below the ribs and to the sides of the body where the kidneys are located) as well as new or worsening confusion (which in older people can also occur with UTIs).

Urinary tract infections are diagnosed by urinalysis or urine culture. Sometimes, a urinalysis (where the urine is tested and results are immediately reported) may help identify an infection. However, for people with recurrent UTIs, it is important to know the specific bacteria responsible, as this determines which antibiotics will appropriately treat it. This process requires a urine culture. A urine culture can take up to 3 days after a sample is provided.

Recurrent urinary tract infections are UTIs that keep happening despite treatment. With time, some bacteria may stop responding to an antibiotic. This is called resistance, which makes effective UTI treatment more difficult.

To ensure the best possible treatment for your UTI symptoms, our specialists will inspect your bladder and urethra and possibly your whole urinary tract system to ensure that treatment with antibiotics alone will control the infection. There are times when your physician will work with other specialists if your treatment requires specific antibiotic therapy.

With recurrent UTIs, it is important to make sure that the antibiotic used has completely cleared the UTI. To check this, a urine culture is repeated. This is called a test of cure (TOC) because it ensures that the treatment has been effective. A TOC is a urine culture that is performed within 7-14 days after completing the last pill of the treatment antibiotic.

Some people with recurrent urinary tract infections may need to take a daily antibiotic for 6-9 months to help prevent another infection after completing the treatment course. This is called a suppression or prophylaxis antibiotic. It is usually a low dose of an antibiotic that has minimal long-term side effects.

Physicians prefer to prevent infections from reaching the kidneys and treat UTIs before they have the potential for causing systemic spread. Recurrent urinary tract infections that involve the kidneys can be serious, requiring strong antibiotics and sometimes even a stay in the hospital. If admitted, the internal medicine team will administer intravenous antibiotics for a few days.