UTI treatment online in Puerto Rico

A urinary tract infection (UTI) happens when bacteria get into the urethra and travel up to the bladder. Most stay in the bladder (cystitis); an infection that reaches the kidneys is called pyelonephritis and is more serious.

Women get UTIs more often because the urethra is shorter. The risk is also higher with recent sex, pregnancy, menopause, diabetes, previous UTIs, kidney stones, a urinary catheter or an enlarged prostate. If you pee often but without burning, it may be something else: see frequent urination.

Doctor online 24/7: video visits for a UTI at any hour. Request a visit online 24/7 and choose your time right away.

To help the doctor evaluate you well by video, have these ready. Not sure whether a video visit or an in-person visit is right for you? Read telehealth or in-person visit: how to choose and how to prepare for your video visit. When you are ready, book your visit.

• Which symptoms you have and since when (for example, burning when you pee or needing to go all the time)
• Whether you have a fever, back or side pain, or vomiting
• Whether you are pregnant or could be
• Past UTIs and which antibiotics worked or did not agree with you
• Your medicines and allergies, and the name of your pharmacy

A UTI is handled in a doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the clinic can’t see you. A doctor’s note after your visit is included at no extra charge.

We do not bill insurance; the lab and the pharmacy charge separately. See all prices. The service is run by The Health Initiative, a nonprofit.

The most common signs of a bladder infection are:

• Pain or burning when you urinate
• Needing to urinate often
• Feeling you need to urinate even when your bladder is empty
• Blood in the urine
• Pressure or cramping in the lower belly or groin
• Cloudy or strong-smelling urine

A bacterial UTI is cured with a prescription antibiotic. There is no single antibiotic for everyone: the doctor chooses the type and length for your case, your allergies, whether you could be pregnant, past infections and the medicines you already take. A simple bladder infection usually needs a short course; it is longer for men, in pregnancy or if the infection has reached the kidneys. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.

The antibiotics used most for a simple bladder infection in women who are not pregnant, per the IDSA (Infectious Diseases Society of America) guideline:

• Nitrofurantoin (one well-known brand is Macrobid): one of the first choices for simple cystitis. It is not used for a kidney infection, because it does not reach the kidney well, and it is avoided if your kidneys do not work well. Take it until the prescription is finished, even if you feel better.
• Trimethoprim-sulfamethoxazole (one well-known brand is Bactrim): used where local bacterial resistance to it is low. It is a sulfa drug: tell the doctor if you are allergic to sulfa, and if you get a rash, blisters or peeling skin while taking it, stop it and get care right away.
• [Ciprofloxacin](route:guide-antibiotics): usually not the first choice for a simple bladder infection. In 2016 the FDA advised that, for a simple bladder infection, this group of antibiotics (fluoroquinolones) be reserved for people with no other option, because of side effects on tendons, muscles and nerves.

The doctor decides which one, if any, is appropriate for you after the evaluation.

Finish the whole course even if you feel better, and drink plenty of water. Per MedlinePlus, bladder infection symptoms most often go away within 24 to 48 hours after treatment begins. If you are not better within 48 hours, or you get worse, tell the doctor in a follow-up visit. To learn when an antibiotic is and isn’t prescribed, read can telehealth prescribe antibiotics.

What about over-the-counter UTI pills? Phenazopyridine, a urinary pain reliever (some lower-strength versions are sold over the counter), eases pain and burning, but MedlinePlus notes it is not an antibiotic and does not cure the infection. It can turn urine red-orange, which is harmless. If symptoms continue, you need an evaluation.

Most bladder infections in women are diagnosed from the symptoms. The doctor gives you an order for a urinalysis and urine culture if you are pregnant, if you are a man, if you get repeated UTIs or symptoms come back after an antibiotic, if you have diabetes or a weakened immune system, or if you are not better within 48 hours. You go to a lab near you, and we go over the result with you in a follow-up visit. If you see blood in your urine, tell the doctor at the start of the visit.

According to the CDC, UTIs are more common in women because the urethra is shorter and closer to the rectum. The risk goes up with recent sex (a UTI is not an STI), pregnancy, and the changes of menopause or spermicide use. If you are pregnant, tell the doctor at the start: a urine test is always ordered.

UTIs are less common in men, and an enlarged prostate raises the risk, especially in older men. Treatment is usually longer than for women, and the doctor orders a urinalysis and urine culture.

Painful urination in men is not always a UTI. MedlinePlus also lists prostate infection (prostatitis), inflammation of the urethra and STIs such as gonorrhea or chlamydia. So the doctor asks about discharge from the penis, your sexual history and testicle pain; if a testicle hurts, read testicular pain, and for STI testing see STI testing and treatment. If you have redness or itching on the head of the penis, see balanitis.

A kidney stone causes severe pain that starts and stops suddenly in the side of the back or the belly, and it can move down toward the groin. It can bring blood in the urine, nausea and vomiting. Stones are confirmed with imaging done in person: if the doctor suspects one, she refers you to where to go. Go to the ER if the pain is not controlled, or if it comes with fever and chills or vomiting. Got a UTI on vacation in Puerto Rico? Visitors are seen by video too.

In babies and young children, a UTI may cause only fever, vomiting, fussiness or poor appetite. Older children may have burning when they pee, belly pain, or new daytime or nighttime wetting after being toilet trained.

The doctor evaluates your child by video with you on camera and, in children, almost always orders a urinalysis and urine culture: we give you the lab order for a lab near you and review the result with you. If appropriate, the doctor prescribes and we send the prescription to your pharmacy. Patients under 21 need a parent or legal guardian on camera with ID. See also our online doctor for kids and fever in children.

For safety: a baby under 3 months with a temperature of 100.4 °F (38 °C) or higher needs the emergency room right away.

The CDC recommends these steps:

• Urinate after sex.
• Stay well hydrated.
• Take showers instead of baths.
• Avoid douching, sprays and powders in the genital area.
• Teach girls to wipe from front to back.

These signs can mean the infection has reached the kidneys or the blood. For your safety, go to the emergency room or call 911. See when to go to the ER.

• Fever with chills, or pain in the back or side
• Vomiting that stops you keeping fluids or medicine down
• New confusion or unusual drowsiness, especially in older adults
• Pregnancy with fever, back pain or blood in the urine
• A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher