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, among other causes.

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

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

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 one of the most common types of outpatient infection 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.

Unfortunately, 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 may be another condition that has UTI-like symptoms

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 most 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.

Underlying conditions

In some cases, UTIs don’t respond to antibiotics because they’re not UTIs at all. Instead, another underlying condition may cause similar symptoms.

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

Cystitis and kidney infections

Both cystitis and kidney infection can be caused by bacteria from a UTI that has spread to the bladder or kidneys.

Doctors typically treat these types of infections with a course of antibiotics. However, some of the potential causes of antibiotic failure for UTIs also apply to these infections, as well.

Sexually transmitted infections (STIs)

In addition, common STIs, such as chlamydia and gonorrhea, also mimic some of the symptoms associated with UTIs.

In the case of an STI infection, antibiotics prescribed for a UTI aren’t likely to be the appropriate treatment for the infection.

If you’ve have UTI-like symptoms that haven’t responded to antibiotic treatment, a doctor will likely recommend additional testing.

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. This includes not holding in your urine, wiping front to back, and peeing after sex.
  • Drink more water: A high water intake can help flush regularly 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. Though additional research is needed, they 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 are 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:

The following includes common questions about UTI symptoms that don’t resolve after antibiotics.

Is it normal to still have UTI symptoms after antibiotics?

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. Or, 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.

What mimics a urinary tract infection?

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.

What are the signs that my UTI is going away with antibiotics?

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