Antibiotic Resistant UTI - Treatments For Urinary Tract Infections

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About antibiotic-resistant urinary tract

infections
Antibiotic-resistant urinary tract infections are a type of infection that do not respond to most – or any
– of the most common treatments. Find out more about antibiotic-resistant urinary tract infections
and the care patients will receive.
Have you ever been diagnosed with an antibiotic-resistant urinary tract infection (UTI) which is
essentially an infection of your water works? This uncomfortable and often painful infection affects 10-
20% of women at some point in their life, and some men, too. You can find out more about UTIs in general
on our common infections (https://www.antibioticresearch.org.uk/about-antibiotic-resistance/bacterial-
infections/common-bacterial-infections/) page, or read on for information about antibiotic-resistant
UTIs.
Antibiotic resistance occurs when the bacteria causing an infection either develop or acquire a
mechanism that protects them against antibiotic treatments.
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resistant infections.
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Who is at risk from antibiotic-resistant urinary tract infections?


Those at greatest risk of antibiotic resistant infections are often those with other underlying medical
conditions, have weakened immune systems either due to illness or as a side-effect of current treatment.
Those often affected have already been taking antibiotics or have been in hospital. Older people, such as
those in care facilities or those undergoing catheterisation may also be affected by ongoing or recurrent
resistant UTIs.

The biggest risk is that untreated or resistant infections (https://www.antibioticresearch.org.uk/about-
antibiotic-resistance/) can lead to kidney problems (like pyelonephritis) or even more serious conditions
like sepsis (or urosepsis). However, it is also very difficult living with the ongoing symptoms of recurring
or antibiotic resistant UTIs.
What type of bacteria usually cause(https://www.antibioticresearch.org.uk/patien
 urinary tract infections? 
The most common bacterial cause of UTIs are E
coli. These bacteria usually live harmlessly in the
gut of healthy people but can cause problems if
they get into the bladder or other parts of the
urinary tract. Uncomplicated infection of the
bladder, also called cystitis, is common and can be
very painful.
Some strains of E. coli bacteria have begun to

produce enzymes called extended-spectrum beta-
lactamases (often summarised to ESBL E coli).
These can make the bacteria resistant to certain
antibiotics, and so the bacteria continue to
multiply and spread. This causes more severe
infection which becomes much more difficult to
treat. Another type of bacteria which often causes
antibiotic resistant UTIs is ESBL klebsiella
pneumoniae. You can read more about extended-
spectrum beta-lactamase-producing bacteria
(ESBLs) here
(https://www.gov.uk/government/publications/extended-
spectrum-beta-lactamases-esbls-treatment-
prevention-surveillance/extended-spectrum-
beta-lactamases-esbls-faqs).
E. coli belongs to the Enterobacteriaceae family of

Gram-negative bacteria. This family of bacteria
also include klebsiella pneumoniae and
enterobacter cloacae. The Enterobacteriaceae
family can all cause UTIs and are often treated

with the beta-lactam antibiotic, carbapenem, for
DONATE
which there areNOW
specific(https://www.antibioticresearch.org.uk/support-
ESBL enzymes. The
carbapenem resistant Enterobacteriaceae (CRE)
that have developed, have become a real risk to
health as the main antibiotic becomes useless and
their presence increases in hospitals and care
settings.

What are the symptoms of an antibiotic-resistant urinary tract

infection?


You can find out more about the symptoms of a UTI on our common infections
(https://www.antibioticresearch.org.uk/about-antibiotic-resistance/bacterial-infections/common-
bacterial-infections/) page. The main difference between a regular UTI and an antibiotic-resistant UTI is
that the medicines usually used to treat such infections do not often work against antibiotic-resistant
UTIs. While the antibiotics may appear to work at first, they are only killing those bacteria sensitive to

the antibiotic, but not dealing with the resistant organisms. This means it is really important that if
DONATE
antibiotic NOW
resistant (https://www.antibioticresearch.org.uk/support-
bacteria are present, they are diagnosed and identified as early as possible so the
right antibiotics are used to kill them.
To identify if you have a UTI, your doctor will usually ask you to provide a urine sample. They will test
your sample with a dip stick. This is a quick way to establish if you have a urine infection. If positive, then a
sample of your urine will normally be sent to the local microbiology laboratory for testing.

Are urinary tract infections contagious?

You cannot pass a UTI on to another person.
However, if you have an infection of any type –
particularly one that is antibiotic resistant – there
is always a risk that the bacteria causing the
infection could infect those around you if you do
not adhere to proper hygiene standards. If you
have an ESBL resistant infection, you will often be
kept in isolation in a hospital ward, to decrease
the risk of spreading these bacteria to other
vulnerable patients. For prevention of UTIs, it is
particularly important that you wash your hands
after using the bathroom and after sexual contact,
and maintain a clean environment.
Find out more about what you can do

antibiotic-resistance/what-can-i-do/) to prevent
the spread of harmful bacteria.
How are antibiotic-resistant urinary tract infections usually

treated?


For most common UTIs, there is usually a ‘first-line’ antibiotic that is often used as standard, although
these vary across the UK. If you have had a UTI, the chances are you are familiar with these drugs. So GPs
will usually follow guidance to treat a UTI immediately with first line therapy according to local
guidelines. If this doesn’t eliminate the infection, a urine culture is often sent to the lab to test what the
bacteria actually is and what antibiotic is likely to kill it. Other antibiotics such as fosfomycin and
pivmecillinam might be used where first line antibiotics have not worked. Fosfomycin is an oral broad-
spectrum antibiotic that acts against many multidrug-resistant pathogens in the urinary tract.
What is colonisation and biofilm?

When people have had several UTIs, and several
courses of antibiotics for a UTI, antibiotics may
initially appear to work and symptoms often
resolve for a while. However, the more resistant
organisms are known to sometimes attach
themselves to the bladder wall as well as forming
colonies of resistant bacteria within other parts of
the body such as the kidney.

These colonies of resistant bacteria can multiply
in DONATE
number overNOW (https://www.antibioticresearch.org.uk/support-
time, and become immune to the
effect of the antibiotics. The bacteria become
harder to eradicate, even when taking powerful
antibiotics, as they form a biofilm. This is where
the colonies of resistant bacteria form a
protective layer around themselves, making it
even more difficult for antibiotics to reach and kill

them.
An antibiotic resistant UTI can then become a
chronic condition and can often cause frequently
recurring outbreaks of infection, with an
increased risk of serious kidney infection
(pyelonephritis) and even sepsis.
What happens if I have a multidrug-resistant urinary tract

infection?


Some strains of bacteria are now resistant to all of the most commonly used antibiotics. When UTIs recur
or don’t go away with treatment, urine samples are usually tested at a microbiology lab. If resistant
organisms are discovered they are often found to be ESBL E. coli or ESBL Klebsiella. If you have a UTI
with either of these resistant bacteria, you will probably be treated in hospital by an infectious disease
doctor and their team. They will often prescribe a specific antibiotic via an intravenous (IV) drip (or
combination of antibiotics) known to be active against ESBL- producing bacteria. This might be
carbapenem antibiotic. These are considered ‘last resort’ antibiotics which are kept especially for those
highly resistant bacterial infections.

If you have an antibiotic-resistant UTI, you’re not alone. There are many different support groups online
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where NOW (https://www.antibioticresearch.org.uk/support-
people suffering with resistant UTIs can help one another.
Preventing UTIs using natural products
Many of those who suffer with recurring 
or
(https://www.antibioticresearch.org.uk/about- (https://www.antibioticresearch.org.uk/patien

resistant UTIs are keen to reduce the risk or
occurrence. They try using natural products to
help with their symptoms. These include D-
Mannose, cranberry products (like triple strength
tablets or juice), Kefir /probiotics, manuka honey
and so on.
Anecdotally, many report finding some of these

useful in the prevention of UTIs; however, there is
very little published evidence to support the
effectiveness of these natural products, and more
research is needed.
How quickly will the infection spread? Is there anything I can do

to stop it getting worse?


The speed at which an infection spreads depends on many factors. This includes the type of bacteria
causing the infection and how long they infection has been present for. The genetics of the bacteria
involved and the health and habits of the person affected is also a factor. It remains important to maintain
good hygiene and follow the advice of your doctor or clinical specialist. You should also let them know if
you notice any changes in your condition. The biggest risk is that the infection is not treated quickly
enough or effectively. This can also increase the risk of developing kidney infection, inflammation or
urosepsis increases. When the bacteria spread from the urinary tract or bladder into the bloodstream, it
is commonly called urosepsis, and can be very serious.

What do I do if I have a question about antibiotic-resistant
infections?
If your question is about your own health, please
contact your GP or medical specialist treating
you.

antibiotic-resistance/)
Are you feeling unwell but the problem is not a support/)
medical emergency? Call 111 (or your own local
Out Of Hours telephone number) to find out
whether you need to attend hospital.
If you are experiencing a health emergency, you

should call 999 or attend your nearest accident
and emergency. Make sure you take all of your
medications with you.
If you are not seeking health advice, but would

like to talk to someone who understands
antibiotic resistance and can help you find more
information, get in touch with our Patient Support
Team
(https://www.antibioticresearch.org.uk/find-
support/support-for-individuals/#pso).
Contact our Patient Support team

on patient.support@antibioticresearch.org.uk
(mailto:patient.support@antibioticresearch.org.uk) or
call them on 07367 784114. Calls are charged at
your usual mobile or landline rate. However, you
can request a call back by text, email or by leaving
a message.
Find out more

Explore our website to find out more
about antibiotics

antibiotic-resistance/antibiotics/), bacteria
antibiotic-resistance/bacterial-infections/types-
of-bacteria/) and the common infections
antibiotic-resistance/bacterial-
infections/common-bacterial-infections/) they
cause, and our research.

Patient Stories
Hear real life stories from patients that have suffered with an antibiotic resistant UTI.


(https://www.antibioticresearch.org.uk/stories/sheila
(https://www.antibioticresearch.org.uk/stories/helens-story/)
story/)
Sheila’s Story
Helen’s Story


(https://www.antibioticresearch.org.uk/stories/rondas-
story/)
Ronda’s Story
Disclaimer: Any medical information referred to in or through our website is given for information purposes only. It is not
intended: to constitute professional advice for medical diagnosis or treatment; to replace consultation with a qualified medical
practitioner; to advocate or recommend the purchase of any product; or to endorse or guarantee the credentials or
appropriateness of any health care provider. You are strongly advised to consult with an appropriate professional for specific
advice tailored to your situation. Instead, information provided on our website is intended to provide helpful signposting
towards further information and support. We aim to provide an opportunity for you to simply share and discuss matters
relating to antibiotic resistance with our Patient Support Officer.
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DONATE NOW (https://www.antibioticresearch.org.

About antibiotic-resistant urinary tract

Looking for patient support?

 Find out more (https://www.antibioticresearch.org.uk/find-support/)

Who is at risk from antibiotic-resistant urinary tract infections?

Some strains of E. coli bacteria have begun to

E. coli belongs to the Enterobacteriaceae family of

What are the symptoms of an antibiotic-resistant urinary tract

Are urinary tract infections contagious?

Find out more about what you can do

How are antibiotic-resistant urinary tract infections usually

What is colonisation and biofilm?

What happens if I have a multidrug-resistant urinary tract

Anecdotally, many report finding some of these

How quickly will the infection spread? Is there anything I can do

If you are experiencing a health emergency, you

If you are not seeking health advice, but would

Contact our Patient Support team

Find out more

relating to antibiotic resistance with our Patient Support Officer.

Sign up to our newsletter

Keep me informed (https://www.antibioticresearch.org.uk/newsletter-opt-in/)

For more information on the issues, or to get involved just contact us

© Antibiotic Research UK 2021

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