Is it possible for a UTI to go away without the use of antibiotics?

By Board Certified Urologist, Dr. Yana Barbalat

Believe it or not, it is! Although there has not been a ton of data, there have been a few studies that followed young and generally healthy women with urinary tract infections and found that about one third of these patients can clear their urinary tract infections without using antibiotics. This data also showed that its very rare for patients to develop complications, such as sepsis or kidney infection, when they delayed treatment with antibiotics¹.

Because of this information, many doctors, especially urologists such as myself, are hesitant to urgently prescribe antibiotics for urinary tract infections. I typically recommend that patients stay well hydrated, take medicine to relieve bladder pain and discomfort (there are several available over the counter), and await urine culture results. The reason urine culture results are important is because we can then prescribe more specific antibiotics for the specific bacteria that is present in the urine. When we do not know what we are treating, we can end up using the wrong antibiotics or antibiotics that are so broad spectrum that they kill a lot of the good bacteria as well.

Occasionally, I find that a patient with a UTI feels better 48 hours later by the time culture results are back. In that case, I usually recommend holding off on antibiotic treatment unless symptoms worsen. This needs to be determined on a case-by-case basis, as some patients such as pregnant women, need antibiotic treatment when they have a UTI regardless if they feel well. 

1. Natural history of uncomplicated urinary tract infection without antibiotics: a systematic review. Hoffmann T, Peiris R, Del Mar C, et al. Br J Gen Pract. 2020 Oct 1;70 (699): e714-e722.