Information for the public

Recurrent urinary tract infections: do I need antibiotics?

Sometimes people keep getting urinary tract infections (recurrent UTIs). This may be because they seem to get rid of an infection but it comes back later, or they have another infection with a different type of bacteria. Recurrent UTIs may affect the bladder (cystitis) or the kidney.

If you are getting recurrent UTIs, there are some things you can do to help prevent them in the future. These include drinking plenty of fluids and trying to avoid waiting when you need to pass urine. Some people may wish to try D‑mannose (a type of sugar you can take every day as a tablet or powder) because some research has shown it can help in women who are not pregnant. You may also want to try cranberry products or probiotics (lactobacillus), although it is not clear from the research how well these work.

Some people with recurrent UTIs are referred to a specialist. These include pregnant women, men, children and young people under 16, and anyone with a recurrent kidney infection. The specialist may suggest you take an antibiotic every day for an agreed time to see if this helps to stop the infections coming back.

Women who are not pregnant can try:

  • an oestrogen cream that you insert into your vagina – this is only suitable if you have had your menopause
  • keeping an antibiotic prescription to use if you know what situations tend to trigger a UTI.

If these don’t help, your doctor may suggest taking antibiotics every day for an agreed time to see if this reduces the number of UTIs you get.

Each of these different options has pros and cons. We’re producing a decision aid to help you discuss them with your doctor and make the right choice for you.

Where can I find out more?

Decisions about treatment and care are best when they are made together. Your health professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns. NICE has developed information (decision aids) to help women to make decisions about treatments for preventing recurrent UTIs.

The NHS website has more information about:

We have also written information on why antibiotics should be used wisely.

We wrote this guideline with health professionals and members of the public. All the recommendations are based on the best research available.

ISBN: 978-1-4731-3127-9

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