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Simple bacterial urinary infections often clear up spontaneously but slowly

In general, simple acute cystitis clears up on its own without complications, but slowly. Antibiotic treatment reduces the duration of the discomfort. The complications of kidney infections are rare but serious, and justify early recourse to antibiotic treatment.

Simple bacterial urinary infections manifest themselves clinically in different ways. In the absence of pregnancy or urinary tract disorders, there is a strong correlation between asymptomatic bacteriuria (bacteria in the urine without urinary discomfort) and sexual activity. Neither urine testing nor systematic treatment is necessary.

A minority of cases of bacteriuria become symptomatic and cause pain on micturation. Uncomplicated lower urinary tract infection (alias simple acute cystitis) often clears up spontaneously but very slowly, which justifies treatment with antibiotics to reduce the duration of the discomfort.

In rare cases, acute cystitis can turn into a severe urinary infection (alias acute pyelonephritis). Acute simple pyelonephritis, which is the most common kidney infection, has several symptoms such as pains in the stomach and back which are exacerbated by examination. The outcome is generally good; however, the risk of rare but serious complications makes early treatment with antibiotics advisable.

©Prescrire February 2007

Source: "Histoire naturelle des infections urinaires bactériennes simples" Rev Prescrire 2007 ; 27 (280) : 118-122.

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