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UTI

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What would you like to know about a urinary tract infection (UTI)?
  • Symptoms and causes
  • Home care and prevention
  • Diagnosis and treatment
  • UTI in pregnancy, men, or children
  • Recurrent UTIs
Seek urgent medical care for fever, flank or back pain, vomiting, confusion, pregnancy with urinary symptoms, or severe illness.

Everything

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A UTI is an infection anywhere in the urinary tract. Most are bladder infections (cystitis), but infection can spread to the kidneys (pyelonephritis), which needs prompt assessment.

Topic map

  1. Types: bladder, kidney, urethral, catheter-associated, recurrent, and complicated UTIs
  2. Causes and risk factors: bacteria, sexual activity, menopause, obstruction or stones, diabetes, catheter use, pregnancy, and prostate enlargement
  3. Symptoms: burning urination, urgency, frequent urination, lower abdominal discomfort, blood in urine, fever, flank pain
  4. Diagnosis: urine dipstick, urinalysis, urine culture, pregnancy testing when relevant, and imaging only in selected cases
  5. Treatment: when antibiotics are appropriate, symptom relief, culture-guided changes, and why leftover antibiotics should not be used
  6. Special groups: pregnancy, men, children, older adults, people with catheters, kidney disease, and immunosuppression
  7. Recurrent UTI prevention: hydration, behavioral measures, post-coital strategies, vaginal estrogen for suitable postmenopausal patients, and limited prophylactic antibiotics
  8. When it is not a UTI: vaginal infection, sexually transmitted infection, kidney stone, overactive bladder, prostatitis, and interstitial cystitis
  9. Red flags: fever, chills, vomiting, back/flank pain, sepsis symptoms, pregnancy, inability to pass urine, or worsening despite treatment

High-level guidance

Typical uncomplicated bladder UTIs cause painful or frequent urination and urgency, often without fever. A clinician may treat based on symptoms and urine testing, but a urine culture is especially useful for pregnancy, recurrent infection, men, severe illness, recent antibiotic exposure, or symptoms that do not improve.
Do not assume confusion or a positive urine test alone proves a UTI in an older adult. Bacteria can be present in urine without infection, and antibiotics are usually not needed unless there are compatible urinary or systemic symptoms.
Get urgent care today for fever, shaking chills, pain in the side/back, vomiting, faintness, confusion, pregnancy with urinary symptoms, or symptoms in a child or a male. These can indicate a kidney infection or a complicated UTI.
Which topic should I explain in detail: symptoms/diagnosis, treatment, prevention of recurrent UTIs, or UTIs in a specific group?

What if kidney is affected how will u give antibiotics

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pyelonephritis AND antibiotics

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acute pyelonephritis treatment antibiotics urine culture hospital admission guidelines 2025

If a UTI has reached the kidney, it is called acute pyelonephritis. It needs medical assessment and a urine culture before the first antibiotic dose whenever possible, so the antibiotic can be changed to match the bacteria’s susceptibility. The NICE pyelonephritis guidance recommends this approach.

How antibiotics are given

1. Mild kidney infection, person is stable A clinician may prescribe an oral antibiotic if the person can drink fluids and swallow tablets, has no signs of sepsis, and can be reviewed promptly. The exact choice depends on:
  • Local antibiotic-resistance patterns
  • Urine culture results
  • Allergy history
  • Pregnancy status
  • Kidney function
  • Recent antibiotic use
Common oral options in guidelines include certain cephalosporins, trimethoprim-sulfamethoxazole only when the organism is known to be susceptible, or a fluoroquinolone only when appropriate. Treatment is generally longer than for a simple bladder UTI, often about 7 to 14 days, depending on the medicine and clinical situation.
2. Severe illness or unable to take tablets Hospital treatment is needed if there is high fever with marked illness, vomiting, dehydration, low blood pressure, confusion, pregnancy, suspected obstruction/stone, immune suppression, or failure to improve. Antibiotics are then given into a vein (IV), often with IV fluids. Examples used in hospitals include IV ceftriaxone, cefuroxime, or other broader agents selected for the patient and local resistance pattern. Once the person is improving and culture results are known, treatment is usually changed to an appropriate oral antibiotic.
3. If kidney function is reduced The clinician checks creatinine/eGFR and adjusts the dose or interval for medicines cleared by the kidneys. Some agents need close monitoring because they can affect kidneys, particularly aminoglycosides such as gentamicin. Do not self-start antibiotics or use leftover tablets in this situation.

Important: antibiotics that should not be used alone for kidney infection

Nitrofurantoin and single-dose fosfomycin can be useful for some uncomplicated bladder infections, but they do not achieve adequate tissue levels in the kidney for pyelonephritis. They are not appropriate treatment for a suspected kidney infection.

When urgent care is needed

Go to urgent care or an emergency department today if there is:
  • Fever or shaking chills
  • Pain in the side or back below the ribs
  • Vomiting or inability to keep fluids/medicine down
  • Feeling faint, very weak, confused, or short of breath
  • Pregnancy
  • Known kidney disease, a kidney stone, catheter, transplant, diabetes with severe illness, or immune suppression
  • No improvement within 48 hours after antibiotics start
Kidney infection with a blocked urinary tract is an emergency: antibiotics alone may fail until the obstruction is drained. Imaging is considered if obstruction is suspected, the person is septic, or there is no response after 48 to 72 hours, as outlined in this clinical evidence review.
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