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UTI treatment online in Puerto Rico: symptoms, care and when to go in person

UTI treatment online in Puerto Rico is possible for many adult women: if you have burning when you pee and a frequent urge to go, are not pregnant, and have no fever or back pain, the doctor can assess you by video and, if appropriate, prescribe an antibiotic. Fever, flank pain, pregnancy, men with symptoms and young children need a urine test or an in-person exam.

Can we help by telehealth? Sometimes: it depends on the evaluation.

Is this an emergency?

This is not an emergency service. Call 911 or go to the nearest emergency room if you have:

  • 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

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Warning signs: when to go to the ER

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UTI symptoms

Most urinary tract infections start in the bladder (cystitis). The most common signs 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

What if the infection reaches the kidneys?

A kidney infection (pyelonephritis) is less common than a bladder infection but more serious. It can cause fever, chills, lower back or side pain, nausea or vomiting. In older adults, confusion is sometimes the only sign.

Those symptoms are not treated by video: you need an in-person evaluation the same day, or the emergency room if you feel very unwell. See when to go to the ER.

Causes and who is at higher risk

Most UTIs are caused by bacteria that enter the urethra and travel up to the bladder. Women get them more often because the urethra is shorter and closer to the anus.

The risk is also higher with recent sexual activity, pregnancy, menopause, diabetes, older age, previous UTIs, a urinary catheter, kidney stones, and anything that blocks the flow of urine, such as an enlarged prostate.

Can a UTI be treated by telehealth?

Sometimes. An uncomplicated bladder infection in an adult woman who is not pregnant is one of the problems best suited to a video visit, because the diagnosis rests mostly on your symptoms and history.

During the visit the doctor will ask when the symptoms started, whether you have fever or back pain, whether you could be pregnant, whether you have had UTIs before, and what medicines you take. From that she decides whether it is safe to treat you without an exam, whether you need a urine test first, or whether you should be seen in person.

If appropriate, the doctor can prescribe medication. We do not prescribe controlled substances. We never promise an antibiotic before the evaluation: read why an antibiotic is not always prescribed. If a test is needed, we can give you a lab order.

UTI treatment

A UTI is treated with a prescription antibiotic. The doctor chooses the type and length based on your case: for a simple bladder infection in women it is usually a short course, and it is longer for men, during pregnancy, or for a kidney infection.

Finish the whole course even if you feel better, and drink plenty of water. Bladder infection symptoms usually improve within 24 to 48 hours of starting treatment; if they don’t, or they come back soon after, contact us or your own doctor again.

Do over-the-counter pills work? An over-the-counter urinary pain reliever (phenazopyridine) eases burning and urgency, but it is not an antibiotic and does not cure the infection. It can mask symptoms while the infection continues.

When you need a urine culture or in-person care

The doctor will ask for a urinalysis and urine culture, or an in-person exam, if:

  • You have fever, chills, or back or side pain.
  • You are or could be pregnant.
  • You are a man: UTIs in men need a fuller evaluation.
  • Your symptoms come back soon after an antibiotic, or you get repeated infections.
  • You have diabetes, a weakened immune system, kidney stones or a urinary catheter.
  • You are not better 48 hours after starting treatment.

Children with UTI symptoms need an in-person urine test

In babies and young children, a UTI may cause few signs other than fever, or vomiting and poor appetite. Older children may have pain when urinating, belly pain, or new daytime or nighttime wetting after being toilet trained.

Confirming a UTI in a child requires a urine test, and in children still in diapers the sample is often collected with a catheter in a medical office. That is why we do not do urine tests for young children by video. The doctor is not a pediatrician: if she suspects a UTI in your child, she will tell you where to have the test done in person.

A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher needs medical care right away. We do not see babies under 6 months. For other questions, see video visits for children and fever in children.

UTI treatment online in Puerto Rico, including for visitors

In an online doctor visit we see you by video while you are physically in Puerto Rico, including visitors and people who have just moved here. If the doctor needs a urine test, you can take the order to a lab in Puerto Rico and she will review the results with you. If you are visiting, see our guide for visitors.

A visit costs US$79 and we do not bill insurance. A prescription or lab order, if the doctor considers it appropriate, has no extra charge; the lab and the pharmacy bill separately. See pricing. If your situation needs in-person care, we tell you during the visit.

How to prevent UTIs

The CDC recommends these steps to lower your risk:

  • 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.

Video visit: US$79 · Pay by card · See the price and what is included

Before you book

  • You must be physically in Puerto Rico during the visit (visitors and tourists are welcome).
  • We see patients from 6 months old. Patients under 21: a parent or legal guardian must be on camera for the whole visit.
  • Real-time video only; we do not do phone-call visits.
  • We do not prescribe controlled substances.

What we don't do by telehealth

Frequently asked questions

Can I get a UTI prescription online in Puerto Rico?
Yes, if you are physically in Puerto Rico during the visit and the doctor judges that it is an uncomplicated bladder infection that is safe to treat without an exam. If a test is needed first, she will give you a lab order. We never promise a prescription before the evaluation.
How do I know if I have a UTI, and what should I do?
Typical signs are burning when you urinate, a frequent urge to go, feeling that your bladder doesn’t empty, and sometimes blood in the urine. If you have no fever or back pain and are not pregnant, a video visit is a reasonable first step. With fever, chills or flank pain, get seen in person.
When is a UTI an emergency?
When there are signs the infection has reached the kidneys or the blood: high fever with chills, severe back or side pain, vomiting that stops you keeping fluids down, or confusion. Go to the emergency room or call 911.

Sources

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