UTI symptoms can linger after a round of antibiotic treatment. This may happen if you have another type of infection with similar symptoms or need a different kind of treatment.

Doctors typically prescribe antibiotics to treat urinary tract infections (UTIs), and they can be effective.

However, sometimes, UTI symptoms don’t go away after antibiotic treatment. In some cases, they worsen instead of improving.

This article explores why an antibiotic may not clear a UTI and what to do about persistent symptoms.

According to a 2019 study, UTIs are among the most common types of outpatient infections in the United States. Antibiotics are the first line of treatment for most UTIs.

Doctors usually prescribe an antibiotic without performing a urine culture first. This is because most UTIs result from an E. coli infection.

But UTI treatments don’t always respond the way they’re expected to. The primary reasons that this may happen include:

  • an antibiotic-resistant strain of bacteria is causing your UTI
  • if you do not take your antibiotic as prescribed or stop taking it before you finish the prescription
  • another type of bacteria, fungi, or virus may be causing your infection
  • your UTI is chronic

Antibiotic resistance

When you have an antibiotic-resistant UTI, it means that the bacteria causing your infection isn’t responsive to antibiotic treatment. This happens when bacteria evolve in response to frequent antibiotic use.

People with underlying medical conditions and weakened immune systems or those who experience recurrent UTIs have the highest risk for antibiotic resistance.

If you do not take your antibiotic prescription as directed, it may affect how well it works. It’s important to finish your course of antibiotics, even if your symptoms seem to improve. Not taking antibiotics as directed may also contribute to antibiotic resistance.

Wrong antibiotics

When a urinalysis is performed without an additional urine culture, there’s a risk that the antibiotic prescribed for your infection may not be the right one.

This can happen when a virus, fungi, or less common bacteria strain is causing your UTI.

This practice may also contribute to antibiotic resistance.

Chronic UTI

Chronic UTIs are infections of the urinary tract that either don’t respond to treatment or keep recurring. They typically recur within a month after treatment or may return multiple times in a year.

Chronic UTIs are most common in females. Risk factors for chronic UTIs include:

  • Using diaphragms during sex: Diaphragms push up against the urethra, making it harder to fully empty your bladder. The urine that doesn’t empty is more likely to grow bacteria.
  • Frequently changing the bacterial makeup of your vagina: This can occur if you use the following products:
  • Menopause: Menopause causes hormone changes that can alter your vaginal bacteria. Vaginal tissues are also thinner and more fragile after menopause.

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In some cases, UTIs don’t respond to antibiotics because they’re not UTIs at all. Instead, they have symptoms that mimic those of UTIs.

Conditions that cause symptoms similar to those caused by a UTI can include:

If you have a UTI that isn’t responding to antibiotic treatment, further testing will likely begin with a urine culture to analyze the bacteria causing the infection.

A doctor will prescribe a more appropriate treatment if another type of bacteria, fungi, or virus is responsible for your UTI. They may also recommend lifestyle changes to help reduce the frequency of UTIs and the severity of your symptoms.

  • Change your hygiene routine: Reducing your risk of UTIs may begin with a few small hygiene changes. These include not holding in urine, wiping front to back, and peeing after sex.
  • Drink more water: A high water intake can help flush bacteria from the urinary tract, reducing the risk of infection.
  • Incorporate more cranberry juice: Cranberries may decrease the risk of recurrent UTIs in people who have had a UTI, though more research is needed.
  • Eat plenty of fruits and vegetables: Fruits and vegetables contain high levels of vitamins and minerals that support the immune system. Be sure to eat produce that has high levels of vitamin C, as it may support immune health and make your urine more acidic, which can reduce harmful bacteria.
  • Consider a supplement: Cranberry extract and garlic extract are just some of the supplements that have been researched as potential UTI treatments. Cranberries and cranberry juice may make it harder for the bacteria to “stick” to the bladder lining. Though additional research is needed, these supplements may help reduce the frequency and severity of UTIs.
  • Take a probiotic: Some probiotics, such as Lactobacillus, may help reduce the risk of recurrent UTIs, though the results of current research are inconclusive. Probiotics are unlikely to cause harm and can help restore good bacteria after a course of antibiotics.

These recommendations work best for UTIs, bladder infections, and kidney infections, as they’re treated similarly.

If you’ve been diagnosed with another underlying condition that’s causing your symptoms, your treatment will likely be different.

Research from 2019 suggests UTI frequency may be linked to an increase in bladder cancer risk. However, the research is sparse.

Two types of cancer can also cause UTI-like symptoms: bladder cancer and prostate cancer.

If you have any of the symptoms listed below, consider making an appointment with a doctor to determine the cause.

Bladder cancer

Bladder cancer symptoms strongly resemble the UTI symptoms. But these symptoms won’t go away with antibiotic treatment and, instead, become more severe over time.

Symptoms of bladder cancer may include:

Prostate cancer

Prostate cancer shares some symptoms with UTIs. Prostate cancer won’t respond to antibiotics, and over time, symptoms can become more severe.

Symptoms of prostate cancer may include:

You may continue to have symptoms after finishing a course of antibiotics for a UTI for a few reasons. Your infection may be caused by a less common bacteria or by a viral or fungal infection.

The bacteria causing your infection may be resistant to the antibiotics you are taking. You may also develop symptoms that are similar to those of a UTI but due to another health condition. In all instances, you may require additional testing and treatment.

Other health conditions, including some STIs and vaginitis, may cause symptoms similar to those caused by a UTI. A doctor can order tests to determine the cause of your symptoms.

If your UTI responds to the antibiotics that you are taking, you may begin to notice your symptoms begin to lessen after starting treatment.

However, be sure to finish your entire course of antibiotics, even if symptoms have stopped.

Treatment typically lasts between 3 days and 6 weeks, depending on the severity of the infection and its response to treatment.

Most UTIs resolve quickly with a course of antibiotics, with most UTI symptoms resolving in a matter of days.

Sometimes, persistent UTI-like symptoms may indicate another issue, such as antibiotic resistance, improper treatment, or an underlying condition.

It’s always important to reach out to a doctor if you’re concerned about UTI symptoms that don’t resolve with antibiotic treatment.