In a woman with burning, frequency and urgency and no vaginal discharge, a urinary tract infection can be diagnosed on symptoms and treated the same day. A short antibiotic course is usual. Around half of episodes settle without one. A telephone consultation is £59.
Message the clinic and a doctor replies within 24 hours.
Any of these needs to be seen the same day. If you are severely unwell, go to your nearest emergency department or call 999.
A urinary tract infection is bacteria growing in the bladder, usually from the person’s own bowel flora. Burning on passing urine, going more often, urgency and lower abdominal discomfort are the four symptoms that matter.New England Journal of Medicine Hooton, 2012
Around half of women have at least one in their lifetime, and it is one of the commonest reasons antibiotics are prescribed. That volume is why prescribing carefully matters here more than almost anywhere else.European Association of Urology EAU guideline, 2024
The anatomy explains most of it. A short urethra means bacteria reach the bladder more easily in women than in men. Sex, a new partner, spermicide use, and after the menopause the fall in oestrogen, all raise the chance.New England Journal of Medicine Hooton, 2012
Recurrent infection means 2 episodes in 6 months or 3 in a year. In a man of any age, or in a woman with visible blood in the urine over 45, the pathway changes from treatment to investigation.NICE NG12, 2015
Send us what you are seeing and we will tell you what it is likely to be.
In a woman with the typical symptoms and no vaginal discharge, the diagnosis is clinical and treatment can start without a test. A dipstick adds little when the symptoms are clear and can mislead in older women, where bacteria in the urine are common without infection.NICE NG109, 2018
A urine culture is sent where symptoms are severe, where they recur, in pregnancy, in men, and where a previous course has failed. That is what identifies the organism and its sensitivities rather than guessing twice.European Association of Urology EAU guideline, 2024
Where infections keep returning, an HbA1c is worth checking. Undiagnosed diabetes presents this way and treating the infection repeatedly without finding it is the commonest missed step.NICE NG28, 2022
Fluids and pain relief, and waiting 48 hours
Around half of uncomplicated episodes resolve without antibiotics. In a randomised trial, most women given anti inflammatory treatment alone recovered, at the cost of a longer illness and a small number of kidney infections in that group.The BMJ Gagyor, 2015
A short antibiotic course
Three days is as effective as longer courses for an uncomplicated bladder infection in a woman, and shorter courses cause fewer side effects and less resistance.NICE NG109, 2018
A back up prescription
The prescription issued but held for 48 hours, used only if things have not settled. It reduces antibiotic use without leaving anyone stuck.NICE NG109, 2018
Vaginal oestrogen after the menopause
For women with recurrent infection after the menopause this reduces episodes and treats the cause rather than each event. It acts locally and can be used long term.NICE NG23, 2024
Prevention where it keeps returning
Behavioural measures, a change of contraceptive method where spermicide is involved, and in some cases a low dose antibiotic taken after sex. Each is chosen against how often it happens and what triggers it.European Association of Urology EAU guideline, 2024
Symptoms usually improve within 48 hours of starting treatment and settle within 3 days. Not improving at 48 hours means the organism is resistant, the diagnosis is wrong, or the infection has reached the kidney, and all three need reassessment rather than a second guess.NICE NG109, 2018
Around a quarter of women have a further episode within 6 months. That is not a treatment failure, it is the natural pattern, and it is the point at which prevention becomes worth more than another course.European Association of Urology EAU guideline, 2024
Any prevention plan is chosen with you rather than issued. A standby prescription, a change of contraceptive method and a low dose antibiotic after sex carry different burdens, and which of those is acceptable is your decision to make once the trade is set out.General Medical Council GMC guidance, 2020
Use the 3 question check. Burning when you pass urine, going much more often, and no vaginal discharge or itch. All 3 present makes a bladder infection much more likely, and discharge instead points somewhere else entirely.New England Journal of Medicine Hooton, 2012
Before you call, note whether you have a temperature and whether you have pain in your side or back. Those two answers are what separate a bladder infection treated by telephone from a kidney infection that has to be seen.NICE NG109, 2018
If you get them after sex, empty your bladder afterwards and check whether spermicide is involved, including on condoms. Changing that one thing resolves a proportion of recurrent cases without any prescription at all.European Association of Urology EAU guideline, 2024
Do not buy cranberry products expecting them to treat an infection. The evidence is that they may reduce how often infections recur in some groups and there is no evidence they treat an episode you already have.Cochrane Database of Systematic Reviews Williams, 2023
Do not buy an antibiotic before speaking to someone if you are over 65 and have no urinary symptoms. Bacteria in the urine without symptoms are common at that age and treating them causes harm without benefit.NICE NG109, 2018
Do not accept a repeat course without a culture if this is your third episode this year. Treating blind for the fourth time is how a resistant organism is missed and how the underlying cause stays hidden.European Association of Urology EAU guideline, 2024
Step 1
15 minutes by telephone. The symptoms, the temperature, any back pain, and whether this has happened before.
Step 2
A prescription where it is right, a back up prescription where waiting is reasonable, and a culture sent where the answer matters.
Step 3
A longer appointment, a culture, an HbA1c, and a prevention plan built around what actually triggers yours.
Ask before you book if you are not sure this is the right appointment.
Yes. A telephone consultation is usually available the same day at £59, and in a woman with typical symptoms and no vaginal discharge a prescription can be issued on that call. Where you are unwell or the picture is not typical you are seen in person instead.
No. Around half of uncomplicated bladder infections settle without them. A randomised trial found most women given anti inflammatory treatment alone recovered, though they were unwell for longer and a small number developed a kidney infection. The choice is yours once you know that.
Three days is as effective as longer courses for an uncomplicated bladder infection in a woman, and shorter courses cause fewer side effects. Men, pregnancy, kidney involvement and recurrent infection all need longer, which is why the assessment matters.
Recurrence is common rather than unusual, and around a quarter of women have another episode within 6 months. Sex, spermicide, the fall in oestrogen after the menopause, and undiagnosed diabetes are the causes worth checking before another course is issued.
It needs to be looked at rather than assumed. Visible blood in the urine over the age of 45 goes on an urgent investigation pathway regardless of whether an infection is present, and we arrange that rather than describing it to you.
Not as a treatment. The evidence suggests cranberry products may reduce how often infections recur in some groups, and there is nothing showing they help an episode you already have. Spending on it instead of being assessed is the wrong trade.
A telephone consultation is £59 and a same day appointment in person is £220. A 30 minute appointment to work out why they recur is £150, and a Core blood panel with HbA1c and kidney function is £350. Antibiotics are dispensed and priced by the pharmacy.
This page is general information about a condition and it is not a diagnosis. Treatment depends on what a doctor finds when they examine you, and no outcome is guaranteed. If you are severely unwell, or if any of the warnings at the top of this page apply to you, go to your nearest emergency department or call 999.
Cochrane Database of Systematic Reviews
Cranberries for preventing urinary tract infectionsWilliams, 2023
European Association of Urology
Guidelines on urological infectionsEAU guideline, 2024
General Medical Council
Decision making and consentGMC guidance, 2020
New England Journal of Medicine
Uncomplicated urinary tract infectionHooton, 2012
NICE
NICE
Urinary tract infection (lower), antimicrobial prescribingNG109, 2018
NICE
Type 2 diabetes in adults, managementNG28, 2022
NICE
Menopause, identification and managementNG23, 2024
The BMJ
Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women, randomised controlled trialGagyor, 2015
Written by the clinical team at The Wellness. Awaiting clinical sign off.
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