Recurrent urinary tract infections: do I need antibiotics?
Sometimes people keep getting urinary tract infections (recurrent UTIs). This may be because they seem to get rid of an infection but it comes back later, or they have another infection with a different type of bacteria. Recurrent UTIs may affect the bladder (cystitis) or the kidney.
If you are getting recurrent UTIs, there are some things you can do to help prevent them in the future. These include drinking plenty of fluids and trying to avoid waiting when you need to pass urine.
If you are a woman, or a trans man or non-binary person with a female urinary system, and are not pregnant, you may wish to try D‑mannose. This is a kind of sugar that can be taken every day as a tablet or powder and which research has found can help prevent UTIs. You may also want to try cranberry products or probiotics (lactobacillus), although it is not clear from the research how well these work.
If you keep getting UTIs you may need to see a specialist, who may suggest you take an antibiotic to see if this helps stop the infections coming back. For example, you will be referred if you are under 16, are a man or a trans woman or non-binary person with a male urinary system, or if you have a recurrent kidney infection.
You will also be referred if you are a pregnant woman, or pregnant trans man or non-binary person. If you are not pregnant, your GP should discuss other options that might suit you. These could include a vaginal oestrogen cream, a one-off antibiotic prescription to only use if you think you’re likely to get an infection or a medicine called methenamine hippurate (this is not an antibiotic).
If these do not help, your doctor may suggest taking antibiotics every day for an agreed time to see if this reduces the number of UTIs you get.
Where can I find out more?
Decisions about treatment and care are best when they are made together. Your health professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns.
The NHS website has more information about:
We have also written information on why antibiotics should be used wisely, in the information for the public section of NICE’s guideline on antimicrobial stewardship.
We wrote this guideline with health professionals and members of the public. All the recommendations are based on the best research available.
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