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Urinary tract infection

Infectio tractus urinarii (cystitis) · Infekce močových cest

What it is

Bacteria (usually E. coli) climb the urethra into the bladder.

Symptoms & signs

  • Burning on passing urine
  • frequency and urgency
  • cloudy smelly urine
  • lower abdominal pain
  • blood in urine
  • confusion in the elderly

🚩 Get help if…

  • see a doctor soon Fever, shivering or pain in the back or side under the ribs
  • see a doctor soon Blood in the urine
  • see a doctor soon Symptoms not better after 2 days of antibiotics
  • see a doctor soon Any urine infection in pregnancy, a man or a child

Where it strikes

Medical treatment

  • Nitrofurantoin or trimethoprim 3–5 days
  • fosfomycin single dose
  • urine culture if recurrent
  • prophylaxis in recurrent cases

Natural & lifestyle

  • Drink an extra 1.5 L a day if intake is low (halved recurrences in a trial)
  • wipe front to back
  • urinate after sex
  • D-mannose 2 g — a large 2024 trial (MERIT) found no fewer recurrences mixed evidence
  • cranberry PACs
  • vaginal oestrogen after menopause

Emerging & experimental

  • MV140 sublingual bacterial vaccine (Uromune)
  • bacteriophage therapy
  • FimH antagonists

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Cranberry products — a 2023 Cochrane review found fewer repeat infections in women and children trials support
  • Methenamine hippurate — the ALTAR trial found it as good as daily antibiotics at preventing recurrences trials support
  • D-mannose — earlier small trials were positive; a large 2024 trial (MERIT) found no fewer recurrences mixed evidence
  • Uva ursi (bearberry) — traditional; a small trial; not for long-term use early / small studies
  • Baking soda and apple cider vinegar — popular; untested anecdotal / traditional

ICD codes