Traditional urine culture and urine PCR are the only tests that can identify the causative organism and identify to which antibiotics it is susceptible. Without organism and resistance identification, the likelihood of incomplete or incorrect treatment increases. Patients may receive multiple or extended courses of antibiotics, increasing the risk of side effects such as gastrointestinal upset, vaginal yeast infections, and even more serious consequences such as progression to a kidney infection or sepsis. A recent study of outpatient urine samples reports that antibiotic resistance was found in over 90% of UTI samples, and 80% of the samples were resistant to at least two drugs.
It is well established that antibiotics use, even in short courses, can alter the normal microbial composition of the gastrointestinal tract and vagina, selecting drug-resistant pathogens. A meta-analysis of five studies of UTIs managed in primary care found an increased risk of antibiotic resistance that persisted for up to one year and a higher risk associated with multiple courses of antibiotics (Pujades-Rodruquez et al., 2019).
The bottom line is that if you have UTI symptoms, make sure that you seek care from a credible medical provider with experience treating urinary tract infections. Urine dipsticks are one tool to assess the presence of cells associated with UTI. Testing with urine culture and/or urine PCR is key to make sure the provider is targeting the correct bacteria with an appropriate course of antibiotics based on organism identification and resistance patterns.
[1] S. Ahmed, A. Alsalloom, I. Babikir, B. Alhoumoud, (2019), "Uropathogens and their antimicrobialvpatterns: Relationship with urinary tract infections." International Journal of Health Sciences. 2019 Mar-Apr; 12 (2): 48-55.
[2] K.-P. Chua, M. A. Fischer, and J. A. Linder (2019). "Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based Cross Sectional Study." BMJ.
[3] M. Davenport, K. E. Mach, L. M. D. Shortliffe, N. Banaei, T. H. Wang, and J. C. Liao, "New and developing diagnostic technologies for urinary tract infections," Nat Rev Urol. 2017;14(5):296-310.
[4] L. T. García, L. M. Cristancho, E. P. Vera, and O. Begambre, "A New Multiplex-PCR for Urinary Tract Pathogen Detection Using Primer Design Based on an Evolutionary Computation Method," J Microbiol Biotechnol. 2015 Oct;25(10):1714-27.
[5] S. LaMotte, (2021, February 24). "Doctors treat female UTIs with wrong antibiotics nearly half the time, study finds," CNN. Retrieved Dec 11, 2022.
[6] A. K. Mambatta, J. Jayarajan, V. L. Rashme, S. Harini, S. Menon, and J. Kuppusamy, (2015). "Reliability of dipstick assay in predicting urinary tract infection," Journal of family medicine and primary care, 4(2), 265–268.
Dr. Mara Holton and Kathleen Mackey first met in 2007 while practicing general urology with a large local urology group. At the time, Dr. Holton had just recently completed her urologic residency at the University of Maryland, and Kathleen had been in practice with the group as a CRNP for just over a year.
Although both practiced general urology, over the years, the majority of their patient population became women experiencing recurrent urinary tract infections, urinary incontinence, uncomfortable vaginal symptoms, and difficulty with sexual activity. They quickly found a common theme that many women had experienced these symptoms for years prior to identifying a provider who could address their concerns. Unfortunately, many patients recounted that, when they did seek help, they were often undertreated, misdiagnosed, or led to believe their symptoms were just something that had to be tolerated. Many women described scenarios of being brushed off by male providers or told that their symptoms were a normal part of aging. As active women and mothers themselves, Mara & Kathleen empathized with the burden these conditions caused and the associated negative impacts on the quality and enjoyment of life. In developing Snippa, a female-focused health care platform, Mara and Kathleen seek to broaden and expand their reach and efforts in order to educate patients about pelvic health and to advocate for access to care, research into , and the development of treatment alternatives for these prevalent health conditions.
Dr. Mara Holton and Kathleen Mackey first met in 2007 while practicing general urology with a large local urology group. At the time, Dr. Holton had just recently completed her urologic residency at the University of Maryland, and Kathleen had been in practice with the group as a CRNP for just over a year.
Although both practiced general urology, over the years, the majority of their patient population became women experiencing recurrent urinary tract infections, urinary incontinence, uncomfortable vaginal symptoms, and difficulty with sexual activity. They quickly found a common theme that many women had experienced these symptoms for years prior to identifying a provider who could address their concerns. Unfortunately, many patients recounted that, when they did seek help, they were often undertreated, misdiagnosed, or led to believe their symptoms were just something that had to be tolerated. Many women described scenarios of being brushed off by male providers or told that their symptoms were a normal part of aging. As active women and mothers themselves, Mara & Kathleen empathized with the burden these conditions caused and the associated negative impacts on the quality and enjoyment of life. In developing Snippa, a female-focused health care platform, Mara and Kathleen seek to broaden and expand their reach and efforts in order to educate patients about pelvic health and to advocate for access to care, research into , and the development of treatment alternatives for these prevalent health conditions.
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