Contents
Introduction
- Brief Overview of UTI:
Urinary tract infections (UTI) are the infections that affect the urinary system. The urinary system removes wastes, toxins, and even harmful bacteria; Failure of the urinary tract to remove the bacteria’s leads to infections. The Urinary tract (kidneys, ureters, bladders and urethra) can be affected by infection, but lower urinary tract (bladder and urethra) is the most common site for infection. UTIs are commonly seen in women due to their anatomy (shorter urethra) than in men.
- Importance of Prevention:
Untreated UTI can lead to spread of infections to the kidneys which can lead to its damage. Untreated UTIs can even lead to fatal conditions like sepsis that can affect the organs. Therefore, it is important to prevent further infections associated with UTI. Antibiotics are the first line agents for the treatment of UTI. OTCs (Over-the-Counter) medications are used as prophylaxis and in the management of symptoms of UTI, but they are not used to directly treat UTI. In this article, we are going to look into OTCs that are used in UTI.
Understanding UTIs
- What is a Urinary Tract Infection?
UTIs can occur at any part of the urinary system, but lower urinary tracts are the most common site for infections. Based on site of infections and symptoms, UTIs are classified as:
- Kidneys: back pain, nausea, vomiting, high fever.
- Bladder: Painful urination, Blood in urine, pelvic discomfort.
- Urethra: Burning sensations with urination, pain.
- Common Causes of UTIs:
The urinary system removes harmful substances including infection causing bacteria, failure of the system can lead to urinary tract infections. The types of bacteria in UTIs are: E. coli,herpes, gonorrhoea, chlamydia and mycoplasma.
- Risk Factors:
The risk factors for causing UTI are:
- Sexual activity: sexually active individuals are more prone to UTIs. Unhealthy sex can lead to infections.
- Female: Females are more prone to UTI due to shorter urethra that causes faster spreading of infections to the bladder. Females after menopause are also prone to UTIs due to declining estrogen circulations. Around 40-50% of women will encounter UTI at least once in their lives, necessitating antibiotic treatment.
- Urinary tract related problems: recent surgeries, catheter usage, blocked urinary tract (Eg, Kidney stones) can also lead to UTIs
- Suppressed immune system: Individuals with compromised immune systems (Eg, Aids) are prone to infections.
The Role of Over-the-Counter Medications in UTI
- What Are OTC UTI Medications?
OTC medications are the drugs that can be bought without a prescription. It can be useful as a prophylaxis or management of UTI, but they cannot be used for treating the infections.
- How OTC Medications Help Prevent UTIs:
OTC medication can be used in managing the symptoms associated with UTI such as pain, and can be used as prophylaxis to prevent recurrence of UTI (RUTI).
- Popular OTC UTI Medications:
The common OTCs that are used in UTI are:
- Cranberry products: The proanthocyanins in cranberry have antibacterial effects by preventing the adherence of bacteria to the cell wall of the urinary tract.
- D-mannose powder: This supplement also prevents the adherence of bacteria to the cell wall of the urinary tract.
- Phenazopyridine Hydrochloride: a urinary analgesic used to treat UTI patients in an outpatient setting. It can help to alleviate symptoms of dysuria, burning sensations, urgency, frequency, and pain associated with UTI.
- Probiotics: Lactobacillus and Bifidobacterium are the beneficial bacteria that can prevent infections by harmful bacteria by competitive exclusion.
- Pain killers: Acetaminophen and ibuprofen can be used for pain and discomfort with UTI.
Benefits of Using OTC Medications for UTI Prevention
- Accessibility and Convenience:
The OTC medications are available at the pharmacies, without the need for a prescription, making them accessible and convenient for immediate use.
- Cost-Effectiveness:
OTC medications are affordable than prescription drugs, thereby reducing the financial burden on patients.
- Ease of Use:
OTC medications have simple, easy-to-administer instructions allowing the patients to be self-reliant.
Awareness about the OTC for recurrent UTI are to be addressed through further studies to determine the OTC usage pattern by the patients.
How to Choose the Right OTC UTI Medication
- Factors to Consider:
- Symptoms: identify the symptoms to select the OTC, but they can only be used to manage the symptoms and not to treat the actual cause.
- Duration of use: OTC are only used for short-term management.
- Active ingredients: The agents that target the specific symptoms are chosen. Eg: Phenazopyridine for pain and burning sensations
- Consulting with a Pharmacist:
The pharmacists can guide you and provide expert advice on using the OTC. Pharmacists can provide vital information like any potential interactions (drug, food interactions) with the OTCs. Pharmacists can advise on the correct dosage and duration of use of the OTC. Therefore, it is important to consult a pharmacist prior to taking an OTC.
Natural Alternatives to OTC Medications
- Herbal Remedies:
Herbal remedies used in UTI based on their actions are:
- Diuretics: increases urine output thereby flushing out the harmful bacteria. Eg: Solidago spp (goldenrod) herb, Levisticum officinale (lovage) root, Petroselinum crispus (parsley) fruit, and Urtica dioica (stinging nettle).
- Antiseptic and Antiadhesive: prevents adhesion of microbes to the cell wall of the urinary tract. Eg: Arctostaphylos uva-ursi (uva ursi), Juniperus spp (Juniper) leaf, and fruit of Vaccinium macrocarpon (cranberry).
Compounds containing berberine also have the same actions. Eg: Mahonia aquifolium (Pursh) Nutt. (Oregon grape) (Berberidaceae) and Hydrastis canadensis L. (Goldenseal) (Ranunculaceae).
- Anti-uropathogenic and Antibactericidal: antibiotic resistance modifying agents (Eg: MDR E.coli). Eg: Anagyris foetida L. (Fabaceae), Lepidium sativum L. (Apiaceae), Gundelia tournefortii L. (Asteraceae), Eruca sativa Mill. (Brassicaceae), and Origanum syriacum L. (Lamiaceae).
- Dietary Changes:
Dietary changes can help prevent and manage UTIs. Eating Probiotic foods like yoghurt; Vitamin C rich foods like oranges; drinking plenty of water to flush out bacteria; opting a vegetarian diet; avoiding alcohol, caffeine, and spicy foods (due to bladder irritations) are the dietary options available.
- Lifestyle Adjustments:
Maintaining personal hygiene, making dietary changes, frequent medical checkups and having healthy sexual practices.
When to Seek Medical Attention
- Recognizing Severe Symptoms:
Seek medical attention immediately if there are the following symptoms:
- High grade fever (101° F)
- Sever pain
- Blood in urine
- Vomiting or Nausea (indicates kidney infections)
- Persistent symptoms even after 2-3 days of antibiotics.
- Understanding When OTC Medications Aren’t Enough:
OTCs are for managing some symptoms, but they are not the cure for UTI. seek immediate medical attention when:
- Symptoms: persisting symptoms seek medical attention
- Recurrent UTIs: frequent UTIs require medical attention
- Complicated UTIs: Patients with diabetes, weakened immune system, or pregnancy associated with UTI are at higher risk requiring medical care.
Conclusion
- UTIs are the infections of the urinary system, and the lower urinary tract is the common site for infections. OTCs are used to manage the symptoms and as a prophylaxis and not to treat the infection itself. Furthermore, it is important to seek immediate medical attention when there are persistent symptoms and complications that cannot be managed with OTCs which require antibiotic therapy.
Source:
- Cranberry Supplement, D-Mannose, and Other OTC Modalities for Prevention of Recurrent UTI in Women Post-Electrofulguration – PMC (nih.gov)
- Urinary tract infection (UTI) – Symptoms and causes – Mayo Clinic
- Phenazopyridine – StatPearls – NCBI Bookshelf (nih.gov)
- Natural therapeutics for urinary tract infections—a review – PMC (nih.gov)
- Treating a UTI Over the Counter: What Works – GoodRx
- When to Go to the Hospital for a UTI: Signs, Complications (healthline.com)
Written By: Ayoob Mansoor, PharmD, RPh