Urinary Tract Infections Affect Millions. The Cures Are Faltering.

Jul 13, 2019 · 18 comments
scientella (palo alto)
Is the future a world where women can no longer have sex for fear of catching a new superbug?
BlueBird (SF)
If men got UTI's as frequently and as painfully as women do, there would probably be more advanced medical care in treating them. Instead, it's women who are stuck begging their doctors for antibiotics for a little relief from the dreadful symptoms. It's the height of sexism in medicine.
Jessica (Colorado)
I wish this article touched on one of the other common causes of UTI's: intercourse. I am very prone to getting them, even without any sexual activity, but I suffered from them multiple times per year when I was younger. Luckily, my doctor informed me of ways to lessen the chances of contracting one after I came in for the third or fourth time. I wish I had been taught these things earlier, and I feel like intercourse is probably a more common cause than chicken.
Mommygoesmum (London)
While living in the UK, I suffered from a UTI that would not quit, or that kept recurring (I wasn't sure). Desperate, I did some online research, and I found D-Mannose, as other commenters have also mentioned. I cannot recommend this enough. My last UTI was more than 2 years ago, after months of dealing with the one that would be treated and come back a couple months later. You can buy D-Mannose online. 3 pills twice a day, with half a glass of water. And even taking it during a UTI will diminish the symptoms, though I would not use it as a cure. I'm not a proselytizer by nature but this is one thing I swear by.
RY (NYC)
As a preventative measure I take cranberry pills. I used to average something like 1 UTI per year, in the past 10 years or so since taking cranberry pills I only had 1 UTI. Works for me as a preventative, not a cure once you have it.
Jenna Ryan (San Diego)
I was on that path myself. I had 8 UTIs in 2014. I was constantly on antibiotics. My doctors even subscribed me antibiotics in bulk to use as a preventive measure. I was terrified of antibiotic resistance, and constantly dealing with the side effects of so many antibiotics. That’s what led me to look into what I could do to get ahead of the issue, and ultimately launch Uqora (www.uqora.com). We make products for people who want to get ahead of UTIs, not just rely on antibiotics (which, as we know, is less and less of an option). We’ve been able to help many thousands of people break the cycle, and are proud to be contributing research to a space that has been chronically under-researched. We’re also currently enrolling for a 360-subject double-blind, placebo-controled clinical trial to advance research on effective prevention for UTIs, an area starving for progress.
MB (Los angeles)
I second D-Mannose. More trials should be done, as it has helped me with both preventing and treating UTIs but does not show up unless you search for “alternative ways to treat UTI”. I feel that the medical industry is slow to adopt more natural remedies even though alternatives are sorely needed given the growing problem of antibiotic resistance.
RW (Manhattan)
Clinical trials are needed for the natural supplement D-Mannose. I found it because it was recommended for my cat! Since then I have read that it is effective in preventing UTIs in people. https://www.ncbi.nlm.nih.gov/pubmed/27424995
Kristina (DC)
Since I never acquired a primary care physician since moving to the area, I recently went to an urgent care clinic with a perceived UTI (one of many I had had that year, and one of many MANY I've had in my lifetime, ever since I was a baby) and since they kept "recurring" was given cipro, which was so strong it caused even mental health changes (an uncommon but well documented side effect). Going to my gyno several months later I discovered that the problem, in fact, were ovarian cysts, which cause similar pain in a similar area (near the bladder). He said the vast majority of urgent care clinics don't even run the urine sample, much less send it to a lab (despite their claims to the contrary). He tested me and found no trace of a UTI. I am someone who is not only highly educated and well-informed but also strongly against antibiotics unless absolutely necessary (for the good of humanity), but this happened to me! I can't imagine how many other women have gone through this. I find that doctors often prescribe antibiotics as a way to make you shut up and go away.
Lawrence Siegel (Palm Springs, CA)
This isn't at all new. 50+ years ago I was a UCLA student who was diagnosed with NSU-non-specific urethritis. After several antibiotics failed and the culture was deemed incurable, I suffered many months of a urinary infection which my body finally healed on it's own. The amazing part of the story was that I met several other young men who suffered with the same diagnosis including a close friend. Mystery antibiotic resistant urinary infections have been around a long time.
Dottie (San Francisco)
The reason why this ailment has been poorly studied is that it overwhelming affects women, and women's pain is considered secondary to men. Most scientific studies only test men. Gender equity in the sciences will hopefully reverse this trend.
K (Canada)
I often get UTIs and I am only in my 20s. I get them randomly even without sexual activity and practicing proper hygiene. Being able to have relatively inexpensive antibiotics and how quickly it reduces symptoms has been such a relief. I have wet the bed before in my sleep because of them. I have been unable to get to sleep because of that slight throbbing pain - just painful enough to keep you from sleeping but not enough to excuse yourself from work the next day. Speaking of work - I feel like I have to pee every few minutes. Impossible to leave the room every few minutes as an elementary teacher. I have worn a pad before in the fear that I may actually wet myself in front of students. Not only these inconveniences - but if left alone a UTI may lead to a more serious kidney infection as stated in the article. It is terrifying to think that antibiotics may not work for me and for other types of infections in the future. They are really necessary and should not be a default measure for things that don't require it. I have tried to convince my parents not to take antibiotics even when they feel the slightest cold coming on... but they are convinced it works.
Bonniwell (Virginia)
@K Look up information on L Reuteri. It's a probiotic that will prevent recurrence of UTIs. It won't cure one, but it will keep them from recurring. I'm also a teacher, and I understand what you are experiencing. I haven't had a UTI since I started taking Reuteri every day--it's been several years. Good luck.
LesISmore (RisingBird)
Antibiotic overuse directly causes resistance in bacteria, whether it is in animal feed or from your doctor. (Though I have a hard time believing that properly cooked chicken alone will spread it to your gut; perhaps it is the lack of proper hand washing that re-transmits resistant bacteria to cooked food) On the opposite side of the examples presented, too many primary care, urgent care, even emergency care physicians and nurses practitioners over diagnose UTI's based on a poorly done urinalysis. For example a woman in her 60's presents with non-specific flu-like symptoms, low grade temperature and 15 white blood cells (WBCs, infection fighting cells) in her urine gets a diagnosis of UTI and a prescription for an antibiotic. They may have ignored two salient facts: the patient has NO symptoms of a UTI, and there are skin cells in the urine which might indicate a contaminated specimen. Asymptomatic pyuria (WBCs) and even bacturia (bacteria) are not UTIs and should not be treated (although there are exceptions.) This article is also "outdated" in as much as these resistant forms of bacteria have been increasing for 10-15 years and good antibiotic stewardship hasn't been practiced long enough to have made an impact, especially in the doctors office. There has been an ongoing initiative, started in 2010, by the Infectious Disease Society of America (IDSA) for 10 new antibiotics by 2020. I've lost track, but I dont think it is happening.
Anna (Princeton)
I think patients are part of the picture that is missing. Women with UTIs are often asked if they "wiped front to back", implying that they got a UTI because they didn't understand basic hygiene. I'm not advocating for a departure from medical intervention or doctors, but I think it needs to be a team effort and there needs to be real discussion about prevention, and an acknowledgment of the pain, instead of the often slightly patronising response from the medical community to women's pain.
K (Canada)
@Anna I agree with all of this - I often get UTIs. My male doctor always insists a culture be done on my urine even though I get UTIs so often I know already know what it is. It is good practice, but it is another few days of suffering. I even hesitate to call it suffering and I wonder if that's where part of the dismissal is - it is simple as far as infections go, with a simple fix and it is just shy of being painful enough to warrant urgent and serious action. As for asking if women have wiped front to back - honestly, I think there is good reason for asking that question. It is scary how little education there has been given that sex and our sexual organs are often talked about in hushed tones due to puritanical and conservative cultures. My own mother did teach me to wipe front to back, but everything else about vaginal/sexual health I learned on my own. It is possible that people may have never received this education.
Mike Kruger (Chicago)
"one crucial path of transfer of germs that cause U.T.I.s is food, most often poultry." So, is this an example where the (over?)use of antibiotics in raising meat is putting our health at risk by speeding up the evolution of drug resistance and/or spreading the resistant strains? I don't have the expertise to provide an informed opinion here, but perhaps those with more knowledge than me could chime in.
Jay David (NM)
Alexander Fleming, the discovered of Penicillin in 1929, correctly predicted at the time that bacteria would evolve resistance to antibiotics, and that overuse of antibiotics would accelerate the process. The result? We feed more antibiotics to our livestock that we actually prescribe to humans, and we overprescribe to humans, and so eventually ALL ANTIBIOTICS will be useless. Furthermore, U.S. companies aren't even developming new antibiotics because they're little profit in a product that needs to be used as little as possible. In the future, new antibiotics will have to be imported. Not only will capitalism do nothing to solve the problem. Capitalism is the actually cause of the problem. As Edward Abbey correctly state, Growth for the sake of growth is the ideology of a cancer cell.