The Growing Problem of Drug-Resistant UTI’s

Are you going to the bathroom every 5 minutes, and it feels like peeing razor blades? You may have a urinary tract infection (UTI). UTIs can be dangerous, and many need treatment with antibiotics, but our treatment options could be dwindling, so ideally, you want to prevent them. 

A 2019 report by an expert panel of the Council of Canadian Academies put the rate of resistance to first-line antimicrobials at 26 percent in Canada. In other words, one in four infections is resistant to the first drug prescribed to treat it. In the US, more than 2.8 million antibiotic-resistant infections occur.

Antimicrobial-resistant UTIs are on the rise and have been since the early 2000s. It is worrisome because, for many women, the frequency and discomfort of a UTI are very real.

Understanding the urinary system 

Your urinary system consists of several parts. The first is your kidneys, which create urine by filtering toxins and excess water from the blood. From each kidney, a small tube called a ureter sends the urine to the bladder, which stores the fluid. Urine is then expelled out of the body from the bladder through the urethra. 

A UTI can occur in any of the parts of the urinary system, most commonly in the urethra and the bladder, where bacteria have an opportunity to pool and grow. When a UTI spreads further and into the kidneys, it is then a kidney infection that can be very painful and more serious and needs to be treated promptly.

Growing microbial resistance 

If you've had a UTI, you know it can produce several unpleasant symptoms, such as frequent urination, painful/burning-like sensation upon urination, cloudy urine, and — less commonly — abdominal pain, fever, or bloody urine. 

While these infections have always been a nuisance, in the past, they could usually be easily treated with a short course of a common antibiotic, such as trimethoprim/sulfamethoxazole (Bactrim), nitrofurantoin (Macrobid), or ciprofloxacin (Cipro). 

Drug-resistant UTIs, however, have made treatment more complex because these commonly used antibiotics may no longer work. Antibiotic resistance can delay therapy with the appropriate antibiotic while the infection progresses to the kidney.

Bacterial resistance occurs when organisms survive exposure to a particular antibiotic and go on to reproduce and pass this survival advantage along. This makes the bacteria impervious to the killing power of the drug. 

Risks after menopause 

Postmenopausal women, because of physiologic and hormonal changes after menopause, can find they are more prone to UTIs. Thinning of the tissue in the vagina, trouble completely emptying the bladder, and lower levels of the hormone estrogen may no longer promote the growth of good bacteria that help keep infectious organisms in check. For this reason, some postmenopausal women may bene!t from a vaginal estrogen cream. 

Staying healthy 

Some — but not all — UTIs can be prevented. Most bacteria that cause UTIs and other human infections live inside our bodies. The bacteria that cause UTIs usually come from the gastrointestinal tract and can be introduced and flourish in the urinary tracked system under certain conditions.

Staying well-hydrated is one way to help prevent UTIs. Frequent urination can flush bacteria from your urinary tract before they start to overgrow. When going to the bathroom, always wipe with toilet tissue from the front of your body toward the back, thus preventing bacteria that safely live near the rectum from getting close to the urethra. Also, avoiding scrubbing, douching, or overly harsh cleansing products can damage the skin, throw off the delicate balance of good to harmful bacteria, and make an infection more likely. 

One tip that seems to help many women is to ensure they void their bladder immediately after intercourse. The physical act of intercourse can help introduce bacteria into the urethra. Going to the bathroom after will ensure that it is eliminated. Yes, go pee!

Treating UTIs 

If you suspect you have a UTI, call your physician or contact one of our prescribing pharmacists. They will ask you questions for a proper assessment; they may even send you a urine test to understand the specific bacteria in your urine. 

Don’t request an antibiotic if they feel you don’t need it. The goal should be to use antibiotics only when they are essential. Limiting use helps prevent the development of antibiotic-resistant strains. Some women with recurrent drug-resistant infections may need to see a urologist to manage their infections better.

If you suspect you have a UTI, contact one of our prescribing pharmacists, who will help assess UTIs and prescribe if indicated.