Antibiotics & Resistence

Antibiotics & Resistence

Reviewed by Board Certified Urologist Dr. Yana Barbalat

If you've had a UTI, then you've definitely been given the standard treatment: antibiotics. While these are definitely a life-saver, antibiotics come with their own drawbacks, too. And if you get recurring urinary tract infections, you're even more at risk of dealing with these nasty side effects AND antibiotic resistance!

But how do antibiotics and work and why exactly can they become bad for you? Let's find out!

Treating and Preventing UTIs with Antibiotics

A cycle of antibiotics is often the first line of defence when it comes to urinary tract infections. They are an effective solution and can make the uncomfortable symptoms disappear in less than 24 hours in some cases.

For chronic urinary tract infection sufferers, low dose antibiotics taken daily for prolonged periods are often offered as the only option for prevention. However, this prolonged exposure to antibiotics causes some unfortunate side-effects. And even then, it's not guaranteed that you will be UTI free, especially when you stop using prophylaxis.

What are Common Antibiotics for Treating UTIs?

Before prescribing an antibiotic for your UTI, your doctor will start by taking a urine sample just to make sure that what you have is, indeed, a UTI. Following this, a medical lab will do what’s known as a urine culture to determine what type of bacteria you have. Once your doctor knows which bacteria caused your UTI, they will prescribe the best antibiotics to treat your particular infection based on what your bacteria is sensitive to. Common antibiotics for treatment of UTIs include Amoxicillin/Augmentin, Bactrim, Macrobid, Cephalexin (Keflex), Ciprofloxacin (Cipro), among several other possible options.

The type of medication, dosage, and the length of use depends on your medical history. Some UTIs are classified as “uncomplicated” and others are classified as “complicated.” This classification depends on the patient’s age, gender, previous history of infections, other medical conditions such as diabetes or neurological disease, and existence of anatomical abnormalities in the urinary tract such as an enlarged prostate or large kidney stones. Those patients who are classified as “complicated” often need a longer course of antibiotic therapy.

Benefits of Using Antibiotics

There are some very good reasons antibiotics are the standard treatment for a UTI. Their benefits are tangible and sometimes even life-saving. Antibiotics for UTIs can:

  • kill infection-causing bacteria that enter the urinary tract from outside the body
  • slow the growth of this bacteria and stop it from spreading from the bladder to the kidneys or prostate
  • begin to take effect within just a few hours

Risk of Using Antibiotics to Treat a UTI

While antibiotics can treat UTIs quickly and effectively, there are also many risks with antibiotic useCommon side effects of antibiotics for UTIs include:

  • yeast infection
  • abdominal pain
  • diarrhea
  • nausea and vomiting
  • headaches
  • skin reactions

There are also some more rare, but very serious side effects of antibiotic use. They include:

  • Severe allergic reactions
  • Tendonitis and tendon rupture
  • Abnormal liver function
  • Neuropathy
  • Severe inflammation and infection of the colon by a bacteria called C.diff, which often emerges after antibiotic use. More on that below….

The Negative Impacts of Antibiotics on the body

While the primary goal of treating a UTI with antibiotics is to kill off harmful bacteria, antibiotics do not discriminate. In other words, they kill off the good bacteria right along with the bad. The problem is, good bacteria are there to protect you from other infections, so when they’re wiped out, it’s possible, or even likely, that you will develop other issues. For instance, approximately 22% of women who receive antibiotic treatment for uncomplicated UTIs develop a vaginal yeast infection. Although over-the-counter yeast infection treatments are abundant, yeast infections, much like UTIs, are often recurrent. Also, as mentioned above, once good gut bacteria is wiped out, there is a risk of developing C. Diff colitis, which is a bacteria that can emerge after antibiotic use. It causes a very serious inflammation of the colon and can even lead to sepsis and death.

Among the more severe impacts of prolonged or repeated antibiotic use are:

What Kind of Bacteria Cause UTIs?

The most common bacteria known to cause UTIs are E.coli (Escherichia coli). While some types of E.coli live in our intestines can even help keep our digestive tract healthy, it's estimated that E.coli bacteria cause 85% of all UTIs from inside our bowels which find their way into the urinary tract.

UTIs can also be caused by other bacteria such as Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus saprophyticus. Because different antibiotics are needed to treat different bacteria, it's important to make sure a urine culture is performed in order to identify which strain of bacteria is causing the UTI. 

Antibiotic Resistance 

The Centers for Disease Control and Prevention (CDC) calls antibiotic resistance “one of the world's most pressing public health problems.” Bacterial resistance to antibiotics has indeed become a global issue–particularly E. coli antibiotic resistance. This is worrying, considering that E. Coli is one of the most common bacterial causes of UTIs. Since UTIs are among the top five reasons that antibiotics are prescribed, there is definitely room to improve the usual UTI treatment protocols. 

If you regularly or even semi-regularly take antibiotics, bacteria will likely build up resistance to that antibiotic over time. This means that the antibiotic may be less effective for you in the future–not just for UTIs but also for other infections. Infections caused by antibiotic-resistant bacteria are challenging to treat and sometimes even impossible.

Is it Possible to Avoid Antibiotics?

Antibiotics are essential and effective at stopping bacterial infections, but they should be used sparingly. The only way to truly reduce the usage of antibiotics is to do your best to prevent UTIs from occurring in the first place.

There does exist a natural alternative for prevention: the cranberry. There are unique bioactive compounds found inside the cranberry that have been clinically proven to control bacteria effectively. These compounds are known as proanthocyanidins (PACs).

However, contrary to popular belief, cranberries, cranberry juice, and most cranberry supplements don't have the amount required to be effective. 

How to Prevent a UTI without Using Antibiotics

To prevent a UTI without the use of antibiotics, try the following home remedies:

  • Stay hydrated. Drinking 6-8 glasses of water (or more) daily dilutes the urine and helps your system flush waste more efficiently, making it more difficult for bacteria to stick to the urinary tract and cause infection.
  • Take probiotics. Good bacteria, AKA probiotics, can help maintain urinary tract health and gut health if you do take an antibiotic. A probiotic called lactobacilli may help prevent UTIs by preventing harmful bacteria from latching onto urinary tract cells and lowering your urine pH, thereby making conditions more hostile to bacteria.
  • Wipe from front to back. Since many UTIs develop when bacteria from the rectum travel to the urethra, be sure to wipe ‘front to back’ after urinating. You might also use separate pieces of toilet paper to wipe the vagina and anus.
  • Practice sexual hygiene. Sex, too, can lead to transfer of bacteria to the urinary tract. Good sexual hygiene can help reduce this. Most notably, this means urinating both before and immediately after sex. Drinking water after sexual activity may help as well by forcing you to pee one more time in the middle of the night. 
  • Take Utiva. Utiva is doctor recommended, 100% natural, and approved by Health Canada. Equal in strength to approximately 9 cranberry pills, each pill contains 36mg of cranberry PACs–the precise amount clinically proven to be effective. With one a day, you can keep UTIs at bay!

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