01-06-2025
Urologists reveal why treating urine infections is getting harder, warn against rising antibiotic resistance
Chances are, at some point in your life, you have had a urinary tract infection (UTI), and, therefore, know that it can be pretty inconvenient and uncomfortable. Be it due to the relentless urge to pee or the pain or burning when urinating. If the infection doesn't go away within days, you may have to take antibiotics. Also read | UTI cases on the rise: Doctor explains it's link with summer heat, shares prevention tips
In an interview with HT Lifestyle, Dr Sanman Gowda, HOD and consultant, urology, KMC Hospital, Mangalore and Dr Mohammed Shahid Ali, consultant, urology, uro-oncology, robotic surgery and renal transplantation, Manipal Hospital Old Airport Road highlighted how the antibiotic resistance of bacteria involved in UTIs is a serious global public health problem.
Dr Gowda said, 'UTI commonly affects both males and females. However, the female gender is more frequently affected. Nearly 50-60 percent women suffer from an episode of UTI at least once in their lifetime. Risk factors associated with UTI include congenital birth defects in the urinary tract, old age, diabetes, kidney stones, and immunosuppression.'
Dr Gowda said that treatment of UTI typically involved antibiotics for 5-7 days. 'In recent years, getting affected by complicated UTIs, for which most antibiotics do not act (resistance), is becoming more frequent. Of late, irrational use of antibiotics has complicated the scenario,' he said.
Why was that the case? Dr Gowda explained, 'There are various reasons for antibiotic resistance, first and foremost being the over-the-counter buying and usage of antibiotics without a medical prescription/ supervision. Second, being either an inappropriate antibiotic, or inappropriate dosage, or an inappropriate duration. The third reason is noncompliance from patients, and the final and most important is the usage of reserve or high-end antibiotics for uncomplicated UTIs. Not getting a urine culture done in recurrent UTIs is also contributory.'
Dr Ali said, 'Treating complicated urinary tract infections is often a challenge we face in day-to-day practice. These cases usually involve patients with underlying issues like diabetes, kidney stones, or catheters, and are caused by more resistant bacteria like Pseudomonas, Klebsiella, or ESBL-producing E coli.'
He added, 'Unlike uncomplicated UTIs that respond to short courses of oral antibiotics, complicated ones often need long-term or even intravenous antibiotics. The real challenge is that many of these bacteria are now resistant to commonly available antibiotics, which limits our treatment options.'
According to Dr Gowda, the antibiotic resistance of bacteria involved in UTIs was a serious global public health problem, leading to increased morbidity and mortality – and there is an urgent need for drastic measures to optimise antibiotic usage. He said, 'Certain bacteria, causing UTI, are now showing resistance to one or more of the commonly prescribed antibiotics, and sometimes resistance to most antibiotics (pan-resistant/multidrug-resistant).'
Dr Ali said, 'With antimicrobial resistance on the rise, the chances of treatment failure, prolonged illness, sepsis, ICU admissions, morbidity, and mortality are higher. This situation may also be attributed to the rampant, indiscriminate over-the-counter availability and usage of antibiotics without proper guidelines in primary care. That's why antibiotic stewardship and better infection control are more important than ever.'
As a way to tackle this 'serious issue', Dr Gowda said there was a need for better antibiotic usage practices and policies, and to create public awareness: 'It is imperative to consult a urologist when you experience symptoms of UTI, like burning urination, increased frequency of urination, lower abdominal or flank pain with associated fever. Patients are advised to take antibiotics only when prescribed by a doctor and to ensure they complete the full course of treatment.'
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
