Cystitis (and other urinary infections)

What doctors say*

* Official guidelines from NICE, NHS and other medical authorities.

Should antibiotics be used? >

Non-pregnant women: immediately or wait 48 hours unless symptoms worsen.

Pregnant women, men, children or young people: immediately depending on severity of symptoms, risk of complications, previous urine culture and susceptibility results,

Prescribers should also take note of previous antibiotic use which may have led to resistant bacteria, and local antimicrobial resistance data.

Likely duration if untreated >

A few days up to many weeks or even longer if established. Between 25-40% of cases will clear up without antibiotics.

Conventional selfcare advice >

  • Drink a lot of extra fluids, mainly water
  • Urinate as soon as the need arises to reduce build up of infection
  • Advise paracetamol or ibuprofen for pain

Opportunities for antibiotic alternatives >

With prescription. Most home remedies are compatible with antibiotic prescription: however check with your doctor to be sure.

Urinary infections such as cystitis, urethritis and (in men) prostatitis are very common infections causing much misery to millions around the world. They are most often caused by E.coli and other ‘gram-negative’ bacteria, and are thus on principle susceptible to antibiotic treatment.

However these bacteria are also likely to develop antibiotic-resistant strains and increasingly the first line of antibiotic treatments (trimethoprim nitrofurantoin) needs extending with others more capable of dealing with resistant strains (penicillins and fosfomycin).

If you have been prescribed an antibiotic it is important that you complete the course (unfinished courses are more likely to engender resistance in your own tract). However the more that urinary infections can be managed without needing antibiotics the better. It will be useful to consider some of the options below.

In self managing urinary infections do watch out for the risk of infection moving up to the kidneys. If you get pain in the abdomen, especially up the sides and to the back, or get fevers, chills, lack of urine, sickness or diarrhoea, report your symptoms to a doctor without delay.

There are no strong self care options for reducing an actual urinary infection if this is confirmed and a suitable antibiotic may be necessary. The focus may be on using the remedies below in a longer term approach to reducing recurring infections.


Traditional home remedies worth trying