Hesperian Health Guides
Infections of the Urine System
HealthWiki > Where Women Have No Doctor > Chapter 23: Problems of the Urine System > Infections of the Urine System
Contents
What causes bladder and kidney infections?
A girl or woman of any age—even a small baby—can get an infection of her urine system.
Infections of the urine system are caused by germs (bacteria). They get into the body from the outside through the urinary opening near the vagina. The lower urine tube that runs next to the vagina is shorter than the urine tube in the penis. This leads to more infections because the germs climb more easily up the short tube into the bladder
Germs can get inside the body and cause infection because of:
- sex. During sex, germs from the penis, vagina, and anus can be pushed through the urinary opening into the urine tube. This is a common cause of bladder infection. It helps prevent infection if you pass urine right after having sex, which washes germs out of the urine tube (but does not prevent pregnancy).
- not drinking enough water, especially when working in the hot sun or in a very hot room and sweating a lot. Germs multiply more quickly in an empty bladder. Try to drink at least 8 glasses or cups (2 liters) of liquid a day. When it is very hot, you need to drink even more.
- not urinating for a long time (for example, when traveling or working). Not flushing out the urine system by urinating allows germs there to multiply which can cause an infection. Try to drink enough to pass urine every 3 to 4 hours.
Teach children to wipe from the vagina toward the anus, front to back, after urinating or passing stool.
- difficulties keeping clean. Try to wash the outside of the genitals every day, and always wipe from front to back after passing stool. Wiping forward can spread germs from the anus into the urinary opening.
- period supplies. Keep the cloths and pads used for your menstrual periods very clean between uses.
- disability, especially those from spinal cord injuries that cause a loss of feeling in the lower body. For more information, see the books Where There Is No Doctor and A Health Handbook for Women with Disabilities.
- having HIV. When HIV is not well-controlled by ART, other infections are harder to fight off.
Signs and treatment
- constantly feeling the need to urinate, even just after urinating
- pain or a burning feeling while passing urine
- pain in the lower belly just after passing urine
- urine smells strong, looks cloudy, or has blood in it. Dark urine can be a sign of hepatitis.
- any signs of bladder infection (see above)
- fever and chills
- pain, often severe, that begins in the lower back and can spread to the front and sides of the body
- nausea and vomiting
- feeling very ill and weak
If you think you are getting a bladder infection:
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- Drink a lot of water. Try to drink at least one cup of water every 30 minutes. This will make you pass urine often. Sometimes the germs will wash out of your urine system before the infection gets worse.
- Stop having sex for a few days or until the signs have gone away.
- If available where you live, make a tea from flowers, seeds, and leaves that are known to help cure urine infections.
STIs, especially chlamydia, can cause a burning feeling when you pass urine.
If you think you have a bladder infection, try these approaches for 1 to 2 days. If the signs do not improve or get worse, start antibiotic medicines (see below). A bladder infection can quickly become dangerous if it moves up the urine tubes to the kidneys.
STIs, especially chlamydia, can cause a burning feeling when you pass urine
Treatment with antibiotics
If you do not feel better in 1 to 2 days, start taking one of the medicines in the box below. A health worker will know the best medicine for where you live, advise if you possibly have a sexually transmitted infection instead, and check for signs of a more serious kidney infection.
| Bladder Infection Medicines |
||
|---|---|---|
| Medicine | How much to take | When and how to take |
| cotrimoxazole | 960 mg | by mouth, 2 times a day for 3 days |
| (cotrimoxazole combines trimethoprim and sulfamethoxazole) | ||
| or nitrofurantoin | 100 mg | by mouth, 2 times a day for 5 days |
| If you do not start to feel better in 2 days (48 hours), the germs where you live may be resistant. | ||
Treatment for a kidney infection:
If you have signs of a kidney infection, such as fever, chills, back pain, or vomiting, it is very important to talk to a health worker and start antibiotic treatment right away. Very serious kidney infections are treated in a health center or hospital.
| Kidney Infection Medicines | ||
|---|---|---|
| Unless laboratory tests show the germs can be treated with only one antibiotic, use 2 medicines. You will need a single injection of ceftriaxone and then one of the antibiotics below, taken by mouth. If ceftriaxone is not available, use ciprofloxacin instead of cotrimoxazole. If your signs do not improve, return to the health center. | ||
| Medicine | How much to take | When and how to take |
| ceftriaxone | 1 gram (1000 mg) | IM, 1 time only |
| and ciprofloxacin | 500 mg | by mouth, 2 times a day for 7 days |
| or cotrimoxazole | 960 mg | by mouth, 2 times a day for 10 days |
| (cotrimoxazole combines trimethoprim and sulfamethoxazole) | ||
Sources
- UpToDate (2022) Patient education: Urinary tract infections in adults (Beyond the Basics)
- UpToDate (2021) Acute complicated urinary tract infection (including pyelonephritis) in adults
- Gupta, et al. (2011) International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women
- Johns Hopkins ABX Guide (2016) Pyelonephritis, Acute, Uncomplicated
- Médecins Sans Frontières (2021) Clinical guidelines - Diagnosis and treatment manual
- UpToDate (2021) Acute complicated urinary tract infection (including pyelonephritis) in adults
- World Health Organization (2021) Model List of Essential Medicines - 22nd list, 2021