A Urinary Tract Infection (UTI) is a bacterial infection affecting the urethra or bladder. It occurs when microbes, usually from the digestive tract, enter the urinary system and multiply. Prompt diagnosis and treatment are important because untreated infections can lead to serious complications. The correct healthcare provider depends on the severity of your symptoms and your history with the infection.
First Line Treatment Options
For most uncomplicated UTIs, the first point of contact is usually a Primary Care Physician (PCP) or a similar general practitioner. PCPs, such as family doctors and internal medicine specialists, are experienced in diagnosing and managing these routine infections. They can perform a quick urinalysis in the office to detect white blood cells and bacteria, confirming the presence of an infection.
Alternative accessible options for immediate care include retail health clinics, often located in pharmacies, and urgent care centers. These facilities are also equipped to handle simple infections and can provide the necessary diagnostic tests. After confirmation, the standard treatment involves a short course of antibiotics, typically lasting three to seven days, to eradicate the bacteria.
First-line antibiotics commonly include nitrofurantoin, often preferred due to low resistance rates, or trimethoprim-sulfamethoxazole, depending on local resistance patterns. The single-dose regimen of fosfomycin is another convenient option. The provider determines the choice of medication and duration based on your medical history. If the initial treatment does not resolve symptoms, a urine culture may be sent to identify the specific bacterial strain and guide the selection of a targeted antibiotic.
When to Seek Urgent or Emergency Care
An infection that has spread from the bladder to the kidneys, known as pyelonephritis, requires immediate medical attention. Symptoms suggesting this progression include a high fever, often exceeding 101°F (38.3°C), accompanied by uncontrollable shaking or chills. Pain in the side, back, or flank area, located just below the ribs, indicates kidney involvement.
You should go to an emergency room or urgent care facility immediately if you experience these severe symptoms alongside nausea, vomiting, or mental confusion. These signs point toward a systemic infection, potentially leading to sepsis, a life-threatening condition. Treatment for pyelonephritis often involves aggressive management, possibly including intravenous (IV) antibiotics and fluids, which are administered in a hospital setting.
When a Specialist is Necessary
While most UTIs are handled by general practitioners, a specialist is necessary when the infection is complicated or recurrent. A recurrent UTI is defined as two or more infections within six months or three or more within a year. In these cases, a urologist is the appropriate specialist, as they focus on conditions affecting the urinary tract in both men and women.
The urologist investigates potential underlying causes beyond simple bacterial introduction, such as structural abnormalities, kidney stones, or issues with bladder emptying. They may perform specialized diagnostic procedures like a cystoscopy, which uses a thin, lighted tube to examine the bladder and urethra, or advanced imaging scans. For women, a Gynecologist or Urogynecologist may also be consulted, particularly if UTIs are linked to hormonal changes or issues with pelvic floor support. These specialists develop a long-term management strategy, which might include low-dose prophylactic antibiotics or non-antibiotic preventative therapies, to break the cycle of recurring infections.