What is the treatment for a urine infection in older people?
- A course of an antibiotic medicine will usually clear the infection quickly. You should see a doctor if your symptoms are not gone, or nearly gone, after a few days.
- Paracetamol or ibuprofen will usually ease any pain, discomfort, or high temperature (fever).
- An underlying cause such as an enlarged prostate or constipation may be found and need treatment.
Note: if you have an infection of your bladder (cystitis) then having plenty to drink is traditional advice to flush out the bladder. However, there is no proof that this is helpful when you have cystitis. Some doctors feel that it does not help and that drinking lots may just cause more toilet trips, giving you more unnecessary pain. Therefore, it is difficult to give confident advice on whether to drink lots or just to drink normally when you have mild symptoms of cystitis. However, if you have a high temperature (fever) and/or feel unwell, having plenty to drink helps to prevent having a lack of fluid in your body (dehydration).
What is the outlook?
Most people improve within a few days of starting treatment. See a doctor if you do not quickly improve. If your symptoms do not improve despite taking an antibiotic medicine then you may need an alternative antibiotic. This is because some germs (bacteria) are resistant to some types of antibiotics. This can be identified from tests done on your urine sample.
Can I prevent urine infections?
Unfortunately, there are few proven ways to prevent urine infections. No evidence has been found for traditional advice given, such as drinking cranberry juice or the way you wipe yourself.
There are some measures which may help in some cases:
- It makes sense to avoid constipation, by eating plenty of fibre (such as fruit) and drinking enough fluid.
- Older women with atrophic vaginitis may wish to consider hormone replacement creams or pessaries. These have been shown to help prevent urine infections.
- If there is an underlying medical problem, treatment for this may stop urine infections occurring.
- For some people with recurring urine infections, a low dose of antibiotic taken continuously may be prescribed.
Further reading and references
Management of suspected bacterial urinary tract infection in adults; Scottish Intercollegiate Guidelines Network - SIGN (updated July 2012)
Guidelines on Urological Infections; European Association of Urology (2015)
Urinary tract infection (lower) - women; NICE CKS, July 2015 (UK access only)
Urinary tract infection (lower) - men; NICE CKS, October 2014 (UK access only)
Rowe TA, Juthani-Mehta M; Urinary tract infection in older adults. Aging health. 2013 Oct9(5). doi: 10.2217/ahe.13.38.
I've been suffering from these for years and tried a million different things. One thing I have learnt for sure is that doctors (GP's and Specialists/Urologists) don't seem to know what they are...Shelley G
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