TUESDAY, June 4 (HealthDay News) -- Some women with symptoms of
a urinary tract infection may be able to skip the antibiotics
typically prescribed and have their symptoms improve or clear,
according to a new Dutch study.
"In healthy people, many mild infections can be cured spontaneously," said study leader Dr. Bart Knottnerus, a researcher at the Academic Medical Center of the University of Amsterdam.
A U.S. expert, however, had a number of cautions about the
findings, including the small number of women studied.
For the research, published May 31 in the journal
BMC Family Practice, Knottnerus recruited women from 20
general medical practices in and around the Netherlands from 2006
to 2008. Women who had contacted their doctor complaining of
frequent urination, painful urination or both were asked if they
would be willing to delay antibiotics -- but only if their symptoms
had been present for no longer than seven days.
Certain women were excluded, including those pregnant or
breast-feeding or those whose immune systems were compromised.
In all, 176 women participated. Of those, 137 were asked to
delay antibiotics and 51 agreed. All the women gave a urine sample
to be analyzed and cultured. The women reported on their symptoms
over the next week.
After a week, 28 of the 51 women willing to delay antibiotic use
still had not used an antibiotic. Twenty of these women (71
percent) reported disappearance or improvement of their symptoms.
Of these 20, more than a third had a positive culture result,
indicating an infection. The researchers did not know the culture
results at the start of the study.
Most of the women not willing to delay antibiotics had a
The women who did agree to delay, Knottnerus said, might be
aware of the bacterial resistance that can result from antibiotic
use. "Furthermore," he said, "in the Netherlands, other mild
infections -- like eye, ear, throat and respiratory infections --
are usually not treated with antibiotics. Therefore, people might
be more receptive to delayed antibiotic prescriptions."
Antibiotics for urinary tract infections usually work within two
or three days. How would an infection clear on its own? "Our
defense mechanisms are strong and often do not need any help from
antibiotics," Knottnerus said. He studied only uncomplicated
infections of the bladder -- defined as those in healthy,
Dr. Jennifer Leighdon Wu, a gynecologist at Lenox Hill Hospital
in New York City, was cautious about the findings. "The number of
women who agreed to delay was 51," she said. "Before changing my
practice, I would like to see much larger numbers."
Checking in with your doctor might uncover some other problem,
she said. "I can't tell you how many people have come in thinking
it's a urinary tract infection and it's a yeast infection," she
In her practice, Wu will sometimes prescribe antibiotics right
away, especially if a woman is in pain. For others, she may wait
until the culture comes back, which usually takes about three days.
"If you can wait until the culture comes back, the patient will
probably receive more appropriate antibiotics," she said, as the
doctor can then target the antibiotic to the organism found in the
"You have to be really careful about who you are asking to forego antibiotic treatment," she said. It could be especially dangerous in older patients. The women in the study, on average, were in their early 40s.
Antibiotics are needed if a woman has symptoms such as fever,
shivering and flank pain, Knottnerus said, as this may indicate the
infection has progressed to the kidneys.
As for cranberry juice, which some women use to self-treat,
Knottnerus said there is no hard evidence that it works to treat
infections, but it may help prevent them.
To learn more about urinary tract infections, visit the
U.S. National Institute of Diabetes and Digestive ...
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