Is my prescription long enough? Why didn’t I get a longer course of antibiotics?
The quick answer to your question about antibiotic length for UTIs
The recommended course of antibiotics for a simple UTI is typically 3-5 days long. The goal is to get rid of the infection without “overexposing” you to antibiotics. Antibiotics wipe out and destroy your good bacteria in addition to killing the UTI bacteria — this can put you at risk for yeast infections and other bacterial infections (more on that below).
If you have done an internet search and believe that you need a longer course of antibiotics, you have likely read about treatment for more complicated UTIs or you read about treatments for men (read more below).
When are courses of 7-14 days used for UTIs?
A longer course of antibiotics is recommended in pregnant women, typically seven days. In cases of more complicated UTIs (also known as kidney infections or upper UTIs) a course is typically 7-14 days. In both pregnancy and complicated UTIs, these typically need to be treated in person because they can be severe and even life threatening.
Lower versus Upper UTI
A lower UTI (also called a simple UTI and/or a bladder infection) causes the typical symptoms of UTI — burning with urination, discomfort in the low abdomen, frequent urination, and an urgent need to urinate.
An upper UTI is more severe and typically affects the kidneys, causing fever, severe back pain, and vomiting. These are typically too severe to be treated through telemedicine.
More antibiotics mean more risk
A longer course of antibiotics can put you at risk for vaginal infections, particularly yeast infections and a bacterial infection called BV (bacterial vaginosis). The antibiotics wipe out the good bacteria in the vagina which lets the small numbers of yeast or other bacteria multiply, get out of control, and cause infection.
Antibiotics can also put you at risk for a serious intestinal infection called C. Difficile Colitis. This infection is very hard to treat, sometimes requires hospitalization, and in some cases can be fatal.
Keeping a UTI treatment course to the recommended 3-5 days helps decrease the risk of these infections.
UTIs in men
UTIs in men are complicated, they can involve the urethra, bladder, kidneys, prostate, testicles, or epididymis (a part of the male reproductive tract). They can be caused by typical UTI bacteria, but in many cases are caused by sexually transmitted infections like gonorrhea and chlamydia. Because these are more complicated infections, they can require a longer length of antibiotics, and require an in-person visit to be diagnosed correctly.