Urinary Tract Infection

What is a Urinary Tract Infection?

And more importantly, how do you get and effectively treat urinary tract infection naturally without having to resort to antibiotics? We will cover these questions and more in the interesting and most comprehensive article about urinary tract infections, otherwise known as UTI. The other term commonly used is cystitis, and what we really mean is an infection of the bladder, but the term cystitis is often used indiscriminately and it really covers a wide range lower urinary tract infections and irritations. Cystitis can be quite uncomfortable indeed, because it causes burning sensations during urination and a often times includes a frequent need to urinate.

How Do You Get Urinary Tract Infections?

majoraggravationMost probably the most frequent cause of cystitis is an infection from intestinal bacteria, and this is particularly the case with women because they have a much shorter urethra (this is the tube through which the urine passes from the bladder to the outside of the body). In most all cases, your urine is sterile (and there will be no micro-organisms present such as bacteria). Estimates are that between 20 to 40 per cent of women will get cystitis during their lifetime.

With the elderly it is possible to have bacteria in the bladder without having any symptoms, I have seen this in many older patients over the years. There can be several reasons why bacteria settling in the bladder in the older person, and here are a few of the main reasons:

  • Inadequate emptying resulting in stagnation of urine may lead to infection. This may be caused by some pharmaceutical drugs (like antidepressants).
  • Immobility or being infirm. Older people tend to stay inside more and move around less which can lead to stagnation
  • Abnormal bladder control, which can be caused by ageing in general or problems with the nerves affecting the bladder.
  • Being constipated.

Even the smallest drop of urine (which is always left behind) may contain bacteria, and conditions that may make it easier for the bacteria to travel through the urethra include those listed below.

Common Causes of a Urinary Tract Infection

Here is a list of the most common causes of a urinary tract infection. This list is by no means complete, but you will find just about all of the most common causes listed here.

  • Toilet Hygiene. This is especially common amongst women, as they have a shorter urethra than men and a woman’s urethra is situated relatively close to their anus (back passage). Women and girls must always wipe themselves from front to back, towards the anus – not the other way around! Correct wiping will help to avoid leading bacteria from their large intestine into their urethra.
  • Stress. Stress results initially in the excess, and eventually in a diminished production of hormones (especially cortisol) which reduce circulating white blood cell counts and contribute to the susceptibility for infection. Many patients I have seen who experience recurrent infection can relate stress (chemical, physical, emotional) to the onset of symptoms.
  • Congenital Deformity In The Urinary System. In the case of repeated infections of the urinary system, particularly among boys and young men, the person should be checked out by a urologist (specialist urinary-tract doctor) carefully for a congenital (present from birth) deformity somewhere in the urinary system which prevents the complete emptying of the bladder.
  • People With A Catheter. Almost every person who has had a catheter fitted (to drain urine) will have some level of bacteria in their bladder, although in many cases usually without symptoms. When their catheter is changed, small lesions (damaged areas of skin) may appear, which may increase the danger of a urinary tract infection and possibly a systemic infection. I have seen several patients in wheelchairs who over the course of years have experienced urinary tract infections many times over.
  • Men With An Enlarged Prostate. An enlarged prostate, particularly in the older male prevents the bladder from emptying completely. This can mean increased urinary retention and a higher chance of cystitis. Other conditions like an infected prostate, which is called prostatitis and urethritis (infection in the urethra) may give rise to similar symptoms in the younger male.
  • Pregnant Women. Pregnant women may be found to be more susceptible to infection because of hormonal change resulting in dilation and reduction in tone of the ureters. Pressure of the uterus on the bladder and local congestion of the veins and pressure may also be factors in cystitis in pregnancy. If a pregnant women is found to have bacteria in her urine, her urine should be cultured, regardless of whether or not she has any symptoms. If their is evidence of bacteria, then it is very important for her to be treated, otherwise, there is the risk of kidney infection and even pre-term delivery if near the due date.
  • Honeymoon Cystitis. Cystitis can be commonly be seen in women related to an increase in their sexual activity, I have seen this many times in my clinic and it will typically present in a women who has recently married, hence the term “honeymoon cystitis”.
  • Venereal Disease. Gonorrhoea and chlamydia infections may cause symptoms similar to cystitis. In addition, there is usually a vaginal discharge, bleeding after sexual intercourse and an inflamed cervix. Cystitis-like symptoms among young sexually active men may be caused by venereal diseases and they should seek immediate medical advice.
  • Parasites. This won’t really be a problem for those living in Western developed nations, but for those who have been in North Africa or the Middle East it can be a real problem. The bladder can be infested by parasites, particularly schistosomiasis or bilharzia. My concerns is for the lack of experience some doctors have with tropical medicine, meaning that doctors practising in New Zealand may not be familiar with diseases of the warmer countries, the tropics. They will see many patients who live in New Zealand but may fail to take account those who have recently lived in Africa or the Middle East. The symptoms of bladder parasites can be quite similar to cystitis, but in this case there will be no bacteria in the urine.
  • Post-Menopausal Women. This is a common one. As a women passes through “the change”, a range of changes take place in her whole body. Due to lack of female sex hormones (oestrogen and progesterone in particular) in postmenopausal women, the urinary system may become more easily irritated by cystitis.
  • Contact Dermatitis. This is a less common and easily overlooked cause of a urinary tract infection. Those using a deodorant or other potentially irritating personal care product around their genitals may develop cystitis-like symptoms.
  • Antibiotics. Overuse of these drugs will select for resistant bacteria, often leading to cystitis.

Symptoms Of A Urinary Tract Infection

The symptoms of a urinary tract infection can vary from person to person, but here is a list of the most likely and common symptoms you will find.

  • Burning sensations or pain during urination.
  • Frequent urination or frequent urging to urinate.
  • Getting up frequently at night to urinate.
  • Cloudy and foul-smelling urine, especially on rising in the morning.
  • Pain directly above the pubic bone.
  • Children under five years of age often have less definite symptoms such as weakness, irritability, reduced appetite and even vomiting.
  • Older women may also have no symptoms other than weakness, recurrent falls, confusion or a fever.
  • Occasional blood or discolouration in the urine.

Who Is at A Risk Of Urinary Tract Infection?

  • Women or girls who do not practice proper toilet hygiene.
  • Women just married or entering into a new sexual relationship.
  • Pregnant women.
  • People with a congenital deformity in the urinary system.
  • Men with an enlarged prostate.
  • People using a catheter.
  • Young people having unprotected sexual intercourse.
  • Living in North Africa or the Middle East.

Good Advice When You Have A Urinary Tract Infection

happygirlIt is important to drink sufficiently, so the bladder is flushed thoroughly. During urination the bladder should be emptied completely. It is a bad habit to sit on the toilet bent forward and reading while urinating. A trick is to place yourself backwards on the toilet, so you lean against the wall. This posture is more suitable in securing a complete emptying of the bladder than the usual sitting posture. Warm clothes on the lower part of the body will also help prevent cystitis.

As a prevention, it may be helpful to drink cranberry juice every day or take capsules. There is no doubt that this simple and natural treatment may help to reduce the frequency of recurrent infections. It is thought that the cranberry juice works by preventing common bacteria from ‘sticking’ to the walls of the bladder and so preventing infection taking hold. Urination immediately after sexual intercourse will flush out most bacteria from the urethra. Try to urinate at least once every three hours. Women who avoid urination for long periods suffer from more infections of the urinary system.

Eric’s Urinary Tract Infection Hints and Tips

  • Take a herbal kidney formula, it can and often will help prevent it and help you recover faster.
  • Drink plenty of clean fresh water, this will help to flush bacteria from your urinary system.
  • Bend forward on the toilet when urinating.
  • Wear warm clothes, especially around the kidney region and lower part of your body.
  • Drink a glass or two of real cranberry juice daily (sugar free!), see further down.
  • Urinate immediately after sexual intercourse will help flush bacteria from your urethra.
  • Never delay in emptying your bladder! Make sure that you try to urinate every two to thee waking hours.
  • Drink water regularly and urinate regularly are the main things to remember with cystitis.
  • Avoid tampons, as they contain additives which may injure the lining of the vagina, use pads instead.
  • Discontinue use of a diaphragm, oral contraceptives & other chemicals used in and around the vagina.
  • Discontinue use of `deodorant soaps’. These soaps are irritating to skin and are responsible for killing off normal external bacteria which are then replaced by more virulent, less easily killed germs.
  • Is urination painful but harmful bacteria cannot be found? Consider discontinuing the use of all types of soaps and use only water to clean the vaginal area. You may want to ask your health-food shop for a glycerin based soap.
  • Using aluminium cookware cause increase the likelihood of cystitis.
  • A repeated UTI ? Then get a Hair Analysis done, you may have excessive levels of cadmium in your body.
  • Food allergies often underpin urinary tract infections, especially recurrent UTIs. Food allergy testing can help to determine if this is the case.
  • Are you young and suffer a lot from stress? It could be one of your leading causes or triggers of a recurring UTI.
  • Are you post-menopausal? Research has found out that a shrinkage of the urethral and vaginal membranes (most commonly occurring after menopause as a result of a reduced level of oestrogen) can increase the likelihood of developing cystitis.

What Are The Medical Treatments For Cystitis?

Drugs_1_1Urinary tract infections would have to be one of the more common reasons why a women will go to her chemist to seek a cure for a condition rather than her doctor. There are various pharmaceutical drugs your pharmacist will recommend to treat cystitis, and they will be generally recommended unless a woman is experiencing blood in her urine or is vomiting. If she is pregnancy with a UTI, she will most probably in all cases be asked to check in with her doctor or report this to her midwife as soon as possible. Usually, a single course of treatment is offered and this will clear up the condition, but if symptoms persist even after trying the OTC (over-the-counter) drug, she will be told to consult her doctor.

How Does Your Doctor Diagnose Cystitis?

urine_sampleThis is easy to explain, your medical doctor will be able to pick up your case of a UTI just by your presenting signs and symptoms. Your urine will be tested with a dipstick (which takes seconds) and a specimen will be taken to a laboratory where it will be cultured to see which bacteria grow in it. Your doctor will want a fresh urine sample, and it is important for the woman to bear in mind that this fresh urine sample is easily contaminated with bacteria from the skin around the vagina. To avoid this occurring, the labia are best separated during this brief urination and the area wiped/cleaned first. If there is any inflammation or redness in the area, your doctor can readily identify any red or white blood cells with another dipstick test.

Your doctor will most probably want to prescribe antibiotics in this case, whilst he or she awaits the results of the urine test. This will also indicate whether the antibiotic is sensitive to the specific bacteria or whether there is any resistant bacteria which is not going to respond to the antibiotic. But what happens if you get a recurrent UTI you ask? Your doctor may in such a case refer you to a specialist who will perform ultrasound scanning or even an X-ray of the urinary system and perhaps a cystoscopy, an examination of the bladder with a minuscule camera.

What Are The Best Natural Treatments For Cystitis?

Alternative MedicineI’m glad you finally asked! Here is some dietary advice, advice on the best nutritional supplements and also the best herbal medicines to use in case of a urinary tract infection. I’ve been treating patients for almost thirty years and in most cases an antibiotic is NOT necessary, especially if you treat any minor urinary disturbances at once. As they say, an ounce of prevention is worth a lot more than a pound of cure. Once you start on the recurring drug merry-go-round to “cure” cystitis, you may well end up like a lot of women I’ve seen and develop a female yeast infection.

Cystitis Dietary Advice

  • Increase intake of water to at least 8 glasses per day. This will help to flush out bacteria, and will reduce pain.
  • Decrease dairy products, citrus juices, and fizzy drinks like sodas.
  • Eat a light diet consisting of grains, some vegetables, and specific drinks such as cranberry juice.
  • Eliminate bladder irritants such as coffee, black tea, and especially alcohol.
  • Discontinue all intake of foods high in sugar including sweet vegetables and fruits, sugar, honey.
  • Chocolate is a major bladder irritant. Avoid sugary foods like the plague!
  • Careful of these foods: Figs, brewers yeast, raisins, avocado, soy sauce, grapes, fava beans, corned beef, nuts, hard cheese, chocolate, apples, peaches, pineapple, cantaloupe, citrus, pickled herring, bananas, yogurt, beer, wine, vinegar, mayonnaise, sour cream, guavas/nectarines.
  • Include celery (preferably organic, commercial celery is sprayed considerably), parsley, and watermelon in your diet.
  • Avoid citrus fruits as they produce an alkaline urine that may encourage bacterial growth. Increasing the acid levels inhibits bacterial growth.

More Lifestyle Advice For Urinary Tract Infections

  • Take a twenty minute (hot if possible) sitz bath every day. A sitz bath helps to relieve the pain associated with a UTI. Add a cup of vinegar (organic apple cider vinegar) to your bath, a sitz bath is essentially a hip bath, you “sit up” in this bath and focus the warmth/heat on the pelvic/leg region. A woman should position her knees up and apart so that the water can enter the vagina. Alternate this vinegar sitz bath with a bath to which you add a few cloves of freshly crushed garlic, this will act as a bactericidal.
  • Use a douche in which you utilise acidophilus yoghurt.

Dietary Supplements For Cystitis

dietary supplementsThe four principal remedies I’d like you to get if you regularly experience UTIs are Buffered C Powder (Thorne Research), D-Mannose Powder from Pure Encapsulations, Body Guard from Doctor Wilson’s Original Formulations and Cranberry Concentrate from Gaia Herbs. All four products can be purchased conveniently from Doctor Supplement Store on this link. You will first need to register, and by purchasing from my store you will be allowing me to continue writing useful webpages just like this one that take a lot of time to write but are very useful for those people who want the best natural medicine treatment advice yet who can’t afford to see a Naturopath!

1. Simple Acute UTI Prevention – This is good if you travel and only want to take something small in your purse or handbag. Body Guard from Doctor Wilson’s Original formulations. Take 15 drops three times daily in a little water before meals. This can be just what you need when you go away on holidays for a week or two to prevent a UTI. It will work – especially if you avoid alcohol when you are away. No cheating!

2. Basic Acute UTI Treatment -This is a good treatment if you have only had a UTI once or twice and not recurrent. New studies show that when it comes to Vitamin C, ascorbic acid irritates the bladder, thus Vitamin C must be obtained in the form of Calcium ascorbate, which is relatively buffered. Avoid vitamins containing any aspartate, as it is a bladder irritant. Try a Vitamin C powder that is PH balanced and in a buffered form already – it is absolutely perfect for those with a urinary tract infection. Try it and see, you will be on top of this complaint in no time, especially if you take Thorne Research Buffered C Powder along with D-mannose powder.

3. Comprehensive Chronic UTI Treatment and Support – This is your best solution if you have recurrent and chronic UTI problems.

  • Order and Take the following 4 products:
  • 1 teaspoon of Buffered C Powder (Thorne Research) twice daily in water before meals.
  • D-mannose Powder (Pure Encapsulations) take one teaspoon twice daily in water away from the Buffered C Powder (about 1/2 hour away)
  • Gaia Herbs Cranberry Concentrate – take 2 liquid filled capsule concentrates twice daily with meals.
  • Body-Guard drops by Doctor Wilson’s Original Formulations.

Buffered C Powder For Cystitis

THR-15502-1This is one of my favorite dietary supplements to recommend for a UTI, and by taking one teaspoon dissolved in a glass of water daily it can help you a long way towards helping to prevent this common infection, especially of you are prone to recurrent UTIs. I highly recommend that you get the Thorne Research Buffered C Powder.

If you have an acute urinary tract infection, take one half to one level teaspoon hourly mixed well into a glass of water along with with half a teaspoon of D-mannose powder (see below). This will give you an excellent immune boost and should help you combat that acute UTI in no time.  Order Buffered C Powder from Thorne Research on this link.

Cranberry Herbal Liquid-Filled Capsules for UTI

Gaia-Herbs-Cranberry-Concentrate-751063403306Apart from drinking cranberry juice, you are probably best to buy a high-quality cranberry herbal supplement and take it daily. Those bottles of juice you get from the supermarket can contain lots sugar, which kind of defeats the purpose of drinking cranberry juice! A good quality cranberry liquid-filled dietary supplement produces plenty of hippuric acid which acidifies the urine and inhibits bacterial growth. There are a few other components in this supplement which stop bacteria from adhering to the bladder wall.

You might be used to reaching for a bottle of cranberry juice from your supermarket for urinary tract relief, but as I previously mentioned, did you know that while the cranberry can help, the sugar added to sweeten their bitter juice just feeds the bacteria that might be causing the irritation in the first place? Fortunately for you, Gaia Herbs Cranberry Concentrate gives you all the power of certified organic cranberries in just 2 convenient, easy to digest capsules, without the sugar (or artificial coloring or additives), for dependable urinary tract relief when you want it most. Order Cranberry Concentrate from Gaia Herbs on this link.

Best UTI Prevention Product For Travel

DWL008_XlI like to recommend Doctor Wilson’s Original Formulations product called Body Guard for my patients for the prevention of UTIs when they travel. This is the best product to take if you think you are getting a “niggle” in the urinary area that may lead to a full-blown UTI. As soon as you experience a symptom as described above, take 10 drops in a tablespoon of water and repeat hourly. You will be amazed at how quickly the condition resolves, all without having to resort to drugs. For optimal results, take the drops in the same water you take some D-mannose powder. The combination of Body Guard and D-mannose is very powerful and should ensure to a high degree that you won’t be getting that UTI. Perfect for when you travel or are away – take both Body Guard and the D-mannose powder with you.

So How does Body Guard Work? Body-Guard is a totally unique liquid formula that contains a carefully balanced, dynamic combination of colloidal silver, herbal medicines and other natural ingredients that have each demonstrated effectiveness in specific health-promoting activities. It is designed to do just what its name implies – act like your personal inner bodyguard to fortify immune function when extra protection is required at your body’s front lines. As a result, you can rapidly gain a healthy, balanced inner environment. It is best to take Body-Guard at the first sign you need it because the faster you act, the faster you will experience results. You may notice its effects within 1 to 2 days, and usually within 7 days optimal results are achieved. Women seeking bladder or urinary support have typically reported fantastic results with several days. It can be used time after time with reliable results, but is not meant to be an every day supplement, and should be taken only when needed.

D-Mannose For UTI

71sPj5t309L._SX522_D-mannose is a naturally occurring sugar that’s closely related to glucose, and I have been using and recommending a white powder called D-mannose for over ten years now in my clinic for UTIs with great success. Research has shown that it really works and can help to prevent a UTI very quickly. In a study involving more than 300 women with a history of recurrent UTIs, researchers treated the women with either two grams of D-mannose, 50 milligrams of an antibiotic, or no treatment daily for six months.

Just 15 percent of those on D-mannose suffered from recurring UTIs in comparison to 20 percent who were taking antibiotics. The BIG thing is this – those taking D-mannose suffered literally no side-effects in comparison to those on the antibiotics who suffered much more with candida yeast infections. Dr. Jonathan Wright from Seattle was among the first doctors to begin using D-mannose for UTIs in the 1980’s, and he found it to be around 85-90 percent effective. This is my experience likewise, I started to use D-mannose in the 1990’s and have treated a few hundred patients and it certainly works and is (in my opinion) what you will want to try before you even contemplate antibiotics.

D-mannose works for helping to prevent the onset of a urinary tract infection and is excellent for prophylaxis (prevention) of UTIs in women who are prone to them. It is also good to treat acute UTIs and is totally safe for women and even children. Order D-Mannose from Pure Encapsulations on this link.

D-Mannose Dosages For UTI Treatment

  • For adults take around 2000mg as a dose (around three-quarters to one teaspoon).
  • For children take from 500mg (1/4 tsp) right up to 2000mg (1 tsp) depending on the age and size (body weight) of the child.
  • Make sure the D-mannose is dissolved very well into a glass of water and repeat this dose every two to three hours.
  • For recurring UTIs, commence with the dosages I have suggested and then gradually taper the dose down as improvement happens. You will find with repeated dosages that the symptoms should disappear within two or three days, and that with recurrent “attacks” and usage of D-mannose that this will reduce quickly to a one day and even half-day recovery, my clinical experience has shown me this.
  • For those young (or older!) ladies who experience honeymoon cystitis (to help prevent post-intercourse UTI) take 1 tablespoon of D-mannose in a glass of water, ensure you urinate after being intimate and then have another glass of water with a further tablespoon of the powder in water. Don’t worry – it’s safe!

Why Does D-Mannose Work for Treating UTIs?

This is simple to explain, more than 90 percent of UTIs are caused by a bacteria called E-coli (Escherichia coli) found in your digestive tract. The problem of a UTI arises when this bug is found and proliferates in an area where it shouldn’t – your urinary system. When normal E. coli gets into your urinary tract and multiplies, you experience the usual signs and symptoms of a UTI:

  • Burning with urination
  • Frequent urges to urinate
  • Lower abdominal pain or aching
  • Blood in your urine (sometimes)
  • Cloudy and/or smelly urine (especially first morning)

The interesting thing about E.coli is that their surface is covered with many microscopic finger-like projections that allow them to easily adhere to the inner walls of your bladder and even work their way up your ureters and kidneys, causing infections their as well. Because they cling so well (a bit like Velcro) it is not that easy to wash them away with just plain old urine. These miniscule finger-like projections are made of a glycoprotein (an amino acid sugar complex) called lectin, and it is this that makes them very sticky.

Mannose however binds very well to those lectins (again, like Velcro) and prevents the E.coli from adhering to the walls of your bladder thereby reducing their numbers quite quickly. This will allow the water you drink (you have got that message by now, haven’t you?) to effectively flush out those nasty E.coli.

If You Have a UTI, Try D-Mannose First

I’d like you to always consider D-mannose powder as a front-line, instead of calling your doctor and taking antibiotics. In my experience as I’ve previously mentioned, once you start on this pathway you may end up like a lot of patients I’ve seen over the years, lots of recurrent UTIs, lots of drugs (and many expensive doctor’s visits), and plenty of side-effects like candida yeast infections.

The antibiotic prescribing will one day come to an end, because the bugs are quickly becoming “super” bugs and outsmarting all those “clever” scientists who keep thinking they can outsmart the bugs. In the 21st Century we are rapidly approaching the end of the antibiotic age, they are widely overused, especially in the animal industry. Use antibiotics wisely, and only when you really need them. That way they will work when you really want them to.

In the majority of cases, UTIs can be effectively treated without antibiotics by using D-mannose.Consider D-mannose your first line of defense, and now that you have read this page and understand exactly how and why it works, does it not make sense? Remember, E.coli accounts for around 90 percent of the bacterial cause and your doctor will be quick to tell you this too. You would wonder why your doctor does not recommend D-mannose powder him or herself! That’s because they weren’t trained to used “non-drug” methods of treating their patients, and that’s OK, that’s why you are reading this webpage right now – you want a natural, drug-free and side-effect free solution.

If you want to be sure if E.coli is your problem or not, your doctor can order a urine culture to identify the particular bacteria present, so you’ll know pretty quickly if yours is one of the minority of cases not caused by E. coli. Chances are if you have used antibiotics many times then you may have already developed a resistance towards the commonly prescribed antibiotics or may have one or several other bacterial strains. EIther way, if you don’t respond quickly to D-mannose treatment – get that urine culture and work out what’s going on.

Occasionally, despite preventative measures, a kidney infection can develop. If you suspect you have a kidney infection (symptoms include fever and pain (ranging from mild to pretty bad) in your back, side, groin, or abdomen, as well as possible blood in your urine it might be necessary to see your doctor & get carefully assessed and maybe and use an antibiotic so the infection does not spread to your kidney, where it can become pretty serious or even lead to the loss of the kidney.

I can asure you this – D-mannose is very safe, even for long-term use, and most women (or the occasional guy) with single episodes of bladder or urinary tract infection will only need it for a few days at most. In the less than 10 percent of cases where the infection is a bacteria other than E. coli, antibiotics can be started in plenty of time. Order D-Mannose from Pure Encapsulations on this link.

But Eric, Isn’t D Mannose A Sugar?

OK, so you have read that D-mannose is a sugar and you are worried about diabetes, candida, etc. Relax! Very little (if any) is actually metabolized, it does not interfere with blood sugar metabolism even for diabetics. From my research I’ve found that it creates no disruption or imbalance in normal body micro-flora and it’s safe even for pregnant women and very small children.

The vast majority of UTIs can be easily cured at home with the methods I’ve outlined above, especially if you follow the hygeine steps, the correct diet and lifestyle choices. I want you to remember this one last thing – stress is one of the KEY triggers and causes of a lowered immune response, and if you are just not recovering, then do an assessment of your lifestyle. Are you living (or working) in a stressful circumstance? Then this may well be that one thing preventing your recovery. Think about it.

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 References

  • BJU International January 2014
  • Townsend Letter May 2014
  • Tahoma Clinic Blog, D-Mannose for Bladder and Kidney Infections
  • Glycoconj J. 2005 Nov;22(7-9):383-94.
  • Tahoma Clinic Blog, D-Mannose for Bladder and Kidney Infections
  • BJU International January 2014
  • National Kidney and Urologic Diseases Information Clearinghouse, UTIs in Adults
  • Cooper, B and Jepson, R. Recurrent cystitis in non-pregnant women. Clinical Evidence Issue 5. June 2001 1338-1345
  • Jepson RG, Mihaljevic L, Craig J. Cranberries for preventing urinary tract infections (Cochrane Review). In: The Cochrane Library, Issue 1, 2000. Oxford: Update Software.
  • Jepson RG, Mihaljevic L, Craig J. Cranberries for treating urinary tract infections (Cochrane Review). In: The Cochrane Library, Issue 1, 2000. Oxford: Update Software.
  • The Cochrane Review Groups are working on further evidence: Expected in Issue 2, 2000:
  • Albert X, Gosalbes V, Huertas I, Pereiró I, Sanfélix J,. Interventions for preventing recurrent urinary tract infection in women (Protocol for a Cochrane Review). In: The Cochrane Library, Issue 1, 2000. Oxford: Update Software. Expected to be published in Issue 2, 2000.
  • Lutters M, Vogt N. Antibiotics duration for treating uncomplicated, symptomatic lower urinary tract infections in elderly women (Protocol for a Cochrane Review). In: The Cochrane Library, Issue 1, 2000. Oxford: Update Software.
  • A Management of suspected bacterial urinary tract infection in adults, a national clinical guideline (88), Scottish Intercollegiate Guidelines Network (SIGN), 2006.

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