What patient education should be provided for a urinary tract infection (UTI)?

Patient Education for Urinary Tract Infection (UTI)

If you have a UTI, complete your full course of antibiotics as prescribed, drink 1.5-2 liters of fluid daily, urinate frequently and completely, and seek medical attention if symptoms persist beyond 2-3 days or worsen despite treatment. 1, 2

Understanding Your Infection

• A UTI is a bacterial infection of your urinary system, most commonly affecting the bladder (cystitis) 3
• Women are 30 times more likely than men to develop UTIs due to anatomical differences 4
• The most common bacteria causing UTIs is Escherichia coli 5, 4

Taking Your Antibiotics Correctly

For women with uncomplicated cystitis, your doctor will prescribe one of these first-line antibiotics: 1

• Fosfomycin: Single 3-gram dose (one-time treatment) 1
• Nitrofurantoin: 50-100 mg four times daily for 5 days, or 100 mg twice daily for 5 days 1
• Pivmecillinam: 400 mg three times daily for 3-5 days 1

For men with UTI, treatment typically requires 7 days of antibiotics rather than the shorter courses used in women 1

• Complete the entire antibiotic course even if symptoms improve after 1-2 days 1
• Do not stop antibiotics early, as this can lead to antibiotic resistance and recurrent infections 6

Self-Care Measures During Treatment

Hydration and urination habits are critical for flushing bacteria from your urinary tract: 2

• Drink 1.5-2 liters (approximately 6-8 glasses) of fluid daily to promote frequent urination 2
• Urinate as soon as you feel the urge—do not hold it 2
• Empty your bladder completely each time you urinate, as incomplete emptying allows bacteria to persist 2
• Urinate immediately after sexual intercourse to flush out bacteria 2

When to Seek Medical Attention

Contact your healthcare provider if: 2

• Symptoms persist beyond 2-3 days of treatment 2
• Symptoms worsen despite taking antibiotics 2
• You develop fever, chills, back pain, nausea, or vomiting (these suggest kidney infection) 1
• Blood appears in your urine and persists after treatment 2

Preventing Future UTIs

Behavioral modifications to reduce UTI risk: 2

• Continue drinking adequate fluids (1.5-2 liters daily) even after infection resolves 2
• Avoid spermicidal contraceptives, including diaphragms with spermicide, as these significantly increase UTI risk 2
• Maintain consistent urination habits (urinate when you feel the urge, empty completely) 2

For postmenopausal women experiencing recurrent UTIs (2 or more infections in 6 months, or 3 or more in 12 months): 1, 2, 7

• Vaginal estrogen therapy is the most effective prevention strategy, reducing UTIs by 75% 7
• This is a cream or ring applied vaginally, not oral estrogen 7
• Vaginal estrogen restores protective vaginal bacteria and does not significantly increase systemic estrogen levels 7
• Discuss this option with your provider—it is safe even if you have a uterus, as absorption is minimal 7

Additional prevention options if recurrent UTIs continue: 1, 2

• Methenamine hippurate (a urinary antiseptic) is strongly recommended for women without urinary tract abnormalities 1, 2
• Immunoactive prophylaxis is strongly recommended for all age groups 1, 2
• Cranberry products may provide modest benefit, though evidence quality is limited 1, 2
• Probiotic supplements containing lactobacillus may help restore protective vaginal bacteria 1, 2

Important Points to Remember

• Do not request antibiotics if you have bacteria in your urine but no symptoms (asymptomatic bacteriuria), as treatment increases antibiotic resistance and future UTI risk 7
• Oral estrogen does NOT prevent UTIs—only vaginal estrogen is effective 7
• Antibiotic prevention should only be considered after non-antibiotic measures have failed, due to risks of resistance and side effects 2, 7
• You do not need a follow-up urine test after treatment if your symptoms resolve completely 7

Special Situations

If you are pregnant, inform your provider immediately, as UTIs require different management during pregnancy 3

If you have diabetes, kidney stones, or use a urinary catheter, you have a complicated UTI requiring closer monitoring and potentially longer antibiotic treatment 3

If you experience recurrent UTIs (3 or more per year), ask your provider about prevention strategies before resorting to continuous antibiotics 1, 2