Can antibiotics give you a urinary tract infection

Bladder infections - two out of three women get well without antibiotics

Today we still know diseases such as tuberculosis, pneumonia and scarlet fever. But they have long since lost their horror. Like many other bacterial infections, antibiotics can treat them very well and effectively. Unfortunately, more and more bacterial strains are becoming resistant to these life-saving drugs. Premature and frequent administration of antibiotics are reasons for this. So that we can continue to treat bacterial infections successfully in the future, antibiotics should therefore be used in a more targeted manner. A study funded by the Federal Ministry of Education and Research (BMBF) shows that this could be implemented in the future for urinary tract infections, as alternative treatment options exist. So far, only a few studies have examined the course of a urinary tract infection under non-antibiotic therapy. Since urinary tract infections are very common, a large number of antibiotic prescriptions could be saved.

The Study: Anti-Inflammatory or Antibiotic?

"It is known that many women who develop urinary tract infections are interested in alternatives to conventional antibiotic treatment," says Dr. Idilkó Gágyor. The general practitioner who led the study at Göttingen University Medical Center gives one reason why so many patients were willing to take part in the study. A total of 494 patients with urinary tract infections were examined in the study and treated with medication. ICUTI, as the study is called, was carried out in 42 family doctor testing practices in Göttingen, Hanover and the surrounding area.

ICUTI is a so-called double-blind, randomized-controlled study. These are studies that provide the highest scientific evidence. Two treatment concepts were compared with regard to efficacy and complications: immediate administration of an antibiotic versus initial treatment with an anti-inflammatory agent and administration of antibiotics only when necessary. Accordingly, there were two treatment groups to which the patients were randomly assigned. A group of 246 patients immediately received an antibiotic. The other 248 patients were given the drug that inhibits inflammation. The women were asked to return to the practice if the symptoms persisted or increased. This made it possible to rule out the possibility of more serious illnesses remaining undetected. The medication was switched to an antibiotic in the event of deterioration.

REGATTA: To be continued

In a follow-up study, doctors are now examining the use of a herbal preparation as an alternative to antibiotics for uncomplicated urinary tract infections. This study is also funded by the Federal Ministry of Education and Research. Your name: REGATTA. It started in February 2016. First results are expected in three years.

The result: antibiotics are not absolutely necessary in many cases

Overall, the group treated with anti-inflammatory drugs had somewhat more severe symptoms. However, two thirds of the women recovered even without antibiotics. In the group with the anti-inflammatories, five women developed kidney inflammation, in the group with antibiotics, however, only one. “We cannot say whether it was coincidence or whether it was caused by the missing antibiotic,” says Gágyor. “One thing is clear: further research must be carried out on this,” explains the doctor. Overall, however, the study participants had fewer severe and less long-lasting symptoms compared with patients who did not want to or could not take part in the study.

The study results apply to patients with mild to moderate symptoms of an uncomplicated urinary tract infection. "We can therefore consider together with patients with mild to moderate urinary tract infection symptoms whether they want to do without antibiotics for the time being," says Dr. Jutta Bleidorn, Head of Studies at the Institute for General Medicine at the Hannover Medical School.

"Likewise, patients who frequently suffer from urinary tract infections will in future be able to start a first attempt at treatment with an over-the-counter drug without consulting a doctor - and would have saved not only the antibiotic but also a visit to the family doctor", adds Gágyor.

For Professor Dr. Eva Hummers-Pradier, Director of the Institute for General Practice at the University Medical Center Göttingen and head of the clinical trial of the ICUTI study, the advice for patients with urinary tract infections could also look different: “As is common in Great Britain, for example, a so-called 'delayed prescription' can also be 'be considered. That means that patients receive a prescription for an antibiotic, which they only redeem if the symptoms do not improve. "

The authors expect their findings to influence future therapy recommendations. "The study results suggest that the non-antibiotic therapy options should be used more," says co-author Dr. Guido Schmiemann from the Institute for Public Health and Nursing Research at the University of Bremen. He is a member of the national guideline group on urinary tract infections. 'Guidelines' are systematically developed aids for doctors that are created in the working groups of the scientific medical societies. They combine the latest scientific findings with tried and tested methods and ensure more safety in medicine.

Antimicrobial Resistance

Since the discovery of penicillin in 1928, antibiotics have been an important means of treating bacterial infectious diseases. However, the bacteria are becoming increasingly resistant to antibiotics. This can be a problem, especially in hospitals. Patients there are becoming infected with such pathogens more and more often.
But why are there more and more antibiotic-resistant germs? The reason: individual bacteria can specifically defend themselves against antibiotics. In their genes, for example, there is information about a substance that can break down antibiotics and thus render them ineffective. Bacteria can quickly exchange this information with one another - so that previously effective antibiotics can no longer harm the germs.

Contact Person:
Dr. med. Ildikó Gágyor
Research coordination
Institute of General Medicine
University Medicine Göttingen
Humboldtallee 38
37073 Goettingen
0551 39-14226
0551 39-9530
[email protected]
www.allgemeinmedizin.med.uni-goettingen.de