Treated quickly it resolves fast. Left too long it reaches the kidneys.
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A urinary tract infection is bacteria multiplying where there should be none. Around 80% are caused by E. coli from the bowel reaching the urethra.
Women get them far more often than men — roughly one in two women will have at least one — for the straightforward anatomical reason that the female urethra is short, so bacteria have a much shorter distance to travel.
Most uncomplicated bladder infections in otherwise healthy women respond to a three-day course of antibiotics, and this is one of the conditions where the value of same-day access is not convenience but symptom relief — an untreated UTI is genuinely miserable and waiting a week for an appointment is a poor experience of healthcare.
Two things on this page matter more than the treatment itself. A UTI in a man is never routine and needs a different approach. And visible blood in the urine needs investigating even after the infection clears — that is the single most important sentence here, and the one most often missed.
Bacteria travelling up to the kidney produces a distinctly different illness:
This needs a different antibiotic, a longer course, and sometimes hospital treatment.
In frail older people a UTI can present as sudden confusion, falls or reduced mobility with none of the classic symptoms.
But the opposite error is at least as common. Bacteria are present in the urine of a large proportion of healthy older people without causing any illness — asymptomatic bacteriuria — and treating that with antibiotics does not help and causes harm. Confusion in an older person has many causes, and a positive urine dipstick is not proof that a UTI is responsible. Dipsticks are unreliable over 65 and current guidance is not to use them in that age group.
Baths, underwear choice, and not drinking enough are all frequently cited. Fluid intake does have some evidence behind it; the others have very little. Nothing about a UTI reflects poor hygiene, and being told otherwise is both wrong and unhelpful.
In a woman under 65 with typical symptoms and no complicating factors, the diagnosis is made on symptoms alone and treatment can begin immediately. Burning, frequency and urgency together, with no vaginal discharge or irritation, gives a high probability of infection — high enough to treat.
Useful in women under 65 where the picture is unclear. Nitrites are the more meaningful finding; leucocytes alone are much less specific. Dipsticks should not be used in the over-65s, where they are positive so often in the absence of infection that they mislead more than they help.
A sample sent to the laboratory identifies the exact organism and which antibiotics will work. It is important, rather than optional, in:
Thrush and bacterial vaginosis cause external stinging that is easily mistaken for cystitis — the distinguishing feature is vaginal discharge or itch. Chlamydia and gonorrhoea cause urethritis with very similar symptoms, and are missed when everyone assumes UTI. Interstitial cystitis produces identical symptoms with repeatedly negative cultures.
Uncomplicated UTI is among the best uses of a same-day remote appointment. The diagnosis rests on the history, and treatment can be with your pharmacy within minutes of the consultation ending.
Treated online first, reassessed in person if it does not settle. That is the sequence, and it is worth stating plainly because it is how most UTIs are safely managed.
Failing to improve is information, not a setback. It usually means resistance rather than anything sinister, and it changes the antibiotic rather than the diagnosis.
UTIs in pregnancy are always treated, including when there are no symptoms, because of the risk of kidney infection and preterm labour. Antibiotic choice is specific: trimethoprim is avoided in the first trimester, and nitrofurantoin is avoided near term. Always tell us if you are or might be pregnant.
Three or more infections a year is worth treating as a problem in its own right rather than as a series of separate events.
We cannot dipstick your urine or take a sample. Where culture is needed we arrange it. Suspected kidney infection, pregnancy with fever, or anyone systemically unwell needs in-person assessment from the outset, and we will direct you there rather than prescribing and hoping.
Call 999 or go to A&E if you have urinary symptoms with:
These are signs of sepsis, which can develop from a urinary infection and progresses quickly.
Seek same-day assessment for:
Visible blood in the urine must be investigated even after the infection has been treated. If you are over 45 and have had visible blood in your urine — with or without an infection — that requires urgent urology referral to exclude bladder cancer. Being told it was "just a UTI" is not a reason to leave it, and we will arrange that referral.
Pharmacy First now treats uncomplicated UTI in women aged 16 to 64 free, same day, without an appointment. That is genuinely the best route for a straightforward UTI in England, and we would point you there before charging you.
Your NHS GP treats UTIs free, and nitrofurantoin and trimethoprim are very cheap generics.
What is worth knowing and costs nothing: a proportion of uncomplicated UTIs settle without antibiotics, and delayed prescribing is a recognised approach in mild cases. Fluids and paracetamol are reasonable first steps.
Where money is wasted: cranberry products and alkalinising sachets, both of which have weak evidence for treating an established infection.
Where a private consultation genuinely earns its fee is recurrent UTI, which is a different problem from a single episode and is frequently managed badly — repeated short antibiotic courses without a plan. The options that actually help are under-offered: vaginal oestrogen in postmenopausal women, which substantially reduces recurrence and is not systemic HRT; methenamine hippurate, which NICE now supports as a non-antibiotic option; and where appropriate, standby or prophylactic regimens.
Sending a urine sample matters more than people think in recurrent infection, since resistance is common and treatment is otherwise guesswork.
What needs urgent care: fever, loin pain, vomiting, confusion — particularly in older people, where confusion may be the only sign. Blood in the urine that persists after treatment needs investigating.
NICE NG109, Urinary tract infection (lower): antimicrobial prescribing, is the governing guideline. It recommends nitrofurantoin or trimethoprim first-line for non-pregnant women, with a three-day course, and considering back-up prescribing where symptoms are mild.
NG109 recommends a urine culture in pregnancy, in men, in recurrent infection, and where treatment has failed.
NICE NG112, Urinary tract infection (recurrent): antimicrobial prescribing, covers prophylaxis and recommends vaginal oestrogen for postmenopausal women with recurrent UTI, and behavioural and personal hygiene measures.
NICE has since supported methenamine hippurate as a non-antibiotic option for preventing recurrent UTI, following the ALTAR trial.
NICE NG111 and NG113 cover pyelonephritis and catheter-associated infection, and NICE NG12 covers visible haematuria as a criterion for urgent urological referral.
Not always. A proportion of mild bladder infections settle on fluids and pain relief alone, and delayed prescribing — holding a prescription for 48 hours to see whether things improve — is a reasonable option for mild symptoms in an otherwise healthy woman. But this is a genuine bacterial infection, symptoms are unpleasant, and there is a real risk of it ascending to the kidney, so treatment is usually the right call.
Most often for a specific and identifiable reason: sexual activity, the menopause, incomplete bladder emptying, constipation, or a contraceptive method. Recurrent UTI is a problem to solve rather than a run of bad luck, and the solution frequently is not more antibiotics — vaginal oestrogen after the menopause, or a change of contraception, resolves a great many.
The evidence is weak and inconsistent. Cranberry capsules or D-mannose are unlikely to do harm, and if you find they help then there is no reason to stop. They are not a treatment for an established infection.
In a woman under 65 with clear, typical symptoms and nothing complicating the picture, yes — that is standard practice and it is what current guidance recommends. Men, pregnant women, children, recurrent cases and treatment failures should all have a urine sample cultured.
No. Sex can trigger one by moving your own bowel bacteria to the urethra, but nothing is being passed from a partner and partners do not need treatment. That said, chlamydia and gonorrhoea cause very similar symptoms, so where there is any risk of exposure, testing for those is sensible.
Persistent bladder symptoms with repeatedly negative cultures may be interstitial cystitis, a non-infective inflammatory condition of the bladder that is often mistaken for recurrent UTI for years. It needs a different approach entirely, and repeated antibiotics will not help.
No, unless they have symptoms themselves. UTIs are not passed between partners.
Possibly, but treat that assumption with caution. Bacteria in the urine are extremely common in older people without causing illness, and a positive dipstick does not prove a UTI is behind the confusion. New confusion in an older person needs a proper assessment for all its possible causes — not simply a course of antibiotics.
August 23, 2026
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20 minutes
Yes, with your consent
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£40 for 20 minutes
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Same day
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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