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UTIs: Why Targeted Treatment Matters
June 7, 2023
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Read Time - 10 minutes
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Around 80% of repeat UTIs are caused by the same organisms. Here's how targeted treatment can help.

Urinary tract infections (UTIs) are one of the top reasons for urgent care and telehealth visits, accounting for more than 8 million appointments a year. Nearly one-half of all women will deal with a UTI at some point in their lives, as will 12% of men.

Yet despite the prevalence of UTIs, testing and treatment options for UTIs highlight room for improvement. Recent data indicates that roughly 60% of antibiotics prescribed for UTIs in the outpatient setting do not conform with clinical guidelines. Even more shockingly, about 40% of women who are experiencing UTIs struggle with repeat urinary tract infections.

If you’ve ever had a UTI, are experiencing UTI symptoms, or have struggled with recurring UTIs in the past, read on. In this blog post, we’ll discuss the importance of a targeted, correct UTI diagnosis, at-home UTI testing options and when to see a doctor about your infection.

Why is a correct UTI diagnosis so important?


Obtaining an accurate diagnosis for a UTI is essential for numerous reasons. It ensures that you receive the correct treatment to alleviate your symptoms and cure the infection, preventing it from spreading to more critical areas, like your kidneys. Misdiagnosis or delayed diagnosis can lead to complications, including kidney damage, recurring UTIs, and, in severe cases, sepsis, a potentially life-threatening condition.

Additionally, diagnosing a UTI correctly helps to avoid the misuse of antibiotics, which can contribute to antibiotic resistance. When the wrong antibiotics are prescribed for a UTI, the antibiotics kill susceptible bacteria, but resistant bacteria can survive and thrive without competition. This makes illnesses caused by resistant bacteria even harder to treat, requiring higher doses, different types of antibiotics or even a combination of several drugs. Therefore, correct UTI diagnosis aids in tailored, targeted treatment, rapid recovery and mitigation of potential complications.

What are my UTI testing options?


There are four primary types of at-home UTI test kits:

  • Dipstick tests: Dipstick tests work by checking for leukocyte (white blood cell) levels as well as levels of nitrite in the urine. The presence of nitrites in the urine is often a key indicator of a urinary tract infection. To use a dipstick test kit, you need to urinate on the test strip supplied with the kit. After a few minutes, the strip will change colors depending on your test results. The test kit typically comes with a color chart to help you interpret your results. Common dipstick brands include AZO and Uqora test strips. Although dipstick tests are one of the most affordable UTI testing options, there is growing concern from the medical community that they are not sensitive enough or specific enough to be used in clinical decision-making for UTI diagnosis and management. In fact, the American Urological Association has stated that urine dipsticks should not be used for diagnosing UTIs, especially in women with repeat infections. This is because while urine test strips can help show indications of possible inflammation, they are not accurate or reliable when diagnosing a UTI. In fact, data shows that urine testing strips or dipsticks do a very poor job of ruling out a bladder infection and provide an accurate result only 30% of the time.
  • Urine culture tests: Urine culture tests involve growing bacteria from a urine sample in a lab. If bacteria is present, it will multiply and form visible colonies over 24-48 hours. Trained lab technicians or microbiologists then identify the type of bacteria. Depending on the type and number of colonies formed, a diagnosis can be made. If a significant amount of a pathogenic (disease-causing) bacteria is found, it usually indicates an infection. Popular urine culture brands include QuestHealth and Ulta Lab Tests. However, this UTI testing method does have its limitations; urine culture tests only identify fast-growing bacteria (not slow-growing bacteria or multiple bacteria coexisting in the urinary tract). This can result in the wrong medication being prescribed for your infection, which may then lead to the continuation of symptoms or a repeat UTI a few weeks or months later.

  • In-home next-generation sequencing (NGS) tests: NGS has the ability to detect hundreds of species of organisms, including pathogens that are difficult to culture. Therefore, it can provide a more comprehensive and accurate understanding of the microbial landscape in UTIs. This in turn can help guide more effective and personalized treatment strategies. However, while this level of detail can be helpful if working with a specialist knowledgeable about advanced testing, the test may result in overtreatment as the testing typically does not provide a direct recommendation for antibiotic selection for treatment. Additionally, NGS tests are only available by request through a urologist or urogynecologist and can reach as high as $1200 or more.

  • PCR tests: PCR tests use a process to “copy” a portion of DNA from your urine sample to identify the precise organism(s) that are causing your UTI symptoms, and can provide a broader view of the bacteria or fungi that are growing in your urinary tract. The PCR technology can identify many different types of pathogens that could be causing your infection— many of which are unrelated to UTI symptoms. One of the most popular PCR tests for UTIs is MyUTI, which focuses on the 12 key pathogens that cause UTI symptoms. This allows patients to get to the root cause of their UTI symptoms with targeted, personalized treatment recommendations. The MyUTI test is purchased online and comes with a urine sample collection kit with instructions for at-home use. Once you've collected your sample, you send the container back to the MyUTI lab with free overnight shipping. Your results will be ready within 24 hours and sent to you via a download link. Once you have your results, you can share them with your doctor or a provider in the Sesame network.

When to see a doctor about your UTI


At-home UTI tests are highly effective at detecting urinary tract infections, but it is still recommended that you talk to a health care provider about your infection and treatment options. Antibiotic medication is needed to completely treat a urinary tract infection and prevent recurrent infections. There are no effective OTC or at-home remedies for UTIs, so you will need to see a health care provider to treat the condition anyway.

Want to see a doctor right away? Sesame offers convenient and affordable video UTI visits so that you can discuss your condition or at-home UTI test results with a licensed health care provider right away. When appropriate, providers on Sesame can write prescriptions and arrange for the medicine to be delivered to your home or ready for same-day pickup at a pharmacy of your choice. Don’t wait to get the care you need.

Sources:

  • Wild, David. IDSE. As UTI Drug Resistance Increases, Treatment Choices Critical. idse.net/Resistance-Stewardship/Article/12-21/As-UTI-Drug-Resistance-Increases-Treatment-Choices-Critical/65723.

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Medical disclaimer

Sesame content is not intended to be a substitute for professional medical advice, diagnosis or treatment. If you have a medical concern, it is critical to seek the advice of your physician or another qualified health provider with any questions. If you are facing a medical emergency, call 911 or visit the nearest emergency room immediately.