Preventing and Treating Urinary Tract Infections in TEOTWAWKI

Disclaimer.  I am not a licensed health practitioner.  This is just another post on knowledge and understanding you might wish to acquire in advance of a disaster in case no higher care is available.  As long as our society is functioning, you should leave anything more substantial than applying a Band-Aid to the professionals.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care. 

The two types of urinary tract infections (UTIs) that we're concerned about are cystitis, which is a bladder infection, and pyelonephritis, which is a kidney infection.  The offending pathogen is most often Escherichia coli, and it wends its way from outside the body up through the urethra to the bladder.

Cystitis.  The urethra is much shorter and straight in women, while it is two to three times as long in men and travels a winding path.  The short, straight shot makes it very easy for women to develop these infections; indeed, women are about twenty times more likely than men to suffer UTIs.   However, women are also much more easily treated.

Men are far less likely to contract a UTI, but when they do, it is also more difficult to treat and must be approached more aggressively. 

Signs and symptoms of a bladder infection include the following:

• Fever
• Painful urination
• More frequent urination
• Lower abdominal pain, especially just above the pubic bone
• Cloudy urine
• Blood in the urine (but not often visible to the naked eye)
• Mental changes, most especially in the elderly

Elderly individuals with a UTI generally have less specific symptoms like confusion and unsteadiness.  A UTI must always be suspected in a confused elder, especially one in whom this change has been fairly rapid. 

A definitive diagnosis is best achieved with urinalysis strips.  A bottle of 100 strips runs about $11.  They've got about a two-year shelf-life unopened, and are good for ninety days after the bottle is opened.  If the dipstick shows protein, blood, and leukocytes, the patient most likely has a UTI. 

Treatment.  A conservative approach to treatment is utilized in women who appear well.  For many, increasing fluid intake to wash the bacteria out will be sufficient.  (That's what they say.  I've never had a UTI, but I hear they're not a lot of fun.  I'm a wimp, and I think I would want to go straight for the antibiotics.  I'm just sharing here what the standard grid-down approach would be.)  Alkalinizing the urine is also recommended by using either 1 teaspoon of baking soda or 1 1/2 teaspoons of cream of tartar mixed in a cup of water.  Vitamin C is also reported to be very helpful as are cranberries and cranberry juice.  Cranberries are not effective for kidney and severe bladder infections. 

Unwell women are prescribed SMZ-TMP (Bactrim, Septra) for three days, and if that is ineffective, then cotrimoxazole or Augmentin for five to seven days.  Men are generally prescribed a longer course of treatment, for seven to ten days.  Other antibiotics that are sometimes used include amoxicillin, nitrofurantoin (Macrobid), ciprofloxacin, and ampicillin. 

Phenazopyridine (Azo, Uristat) is recommended for reducing the pain of urination.  Be aware that it will turn the urine a reddish-brown temporarily.  

Prevention.  The incidence of UTIs can be reduced or eliminated by practicing the following:

• Wipe front to back
• Urinate after intercourse
• Go when you need to go
• Refrain from taking bubble baths or using strong soap on the genitals

Pyelonephritis.  The symptoms of a kidney infection are similar to those of a bladder infection, but much more severe.  There is more pain and a higher fever, often accompanied by nausea and vomiting.  The pain may radiate from the back just below the ribs and down to the thighs.  The same antibiotics are used, but for ten to fourteen days.  Failure to treat pyelonephritis may result in sepsis and death. 
 
Herbs used to treat bladder and kidney infections include:

• Arrowroot, 2 teaspoons per cup of water
• Mullein root tincture, 30-60 drops, 2-3 times per day
• Juniper needle infusion, 2 cups of boiling water over 1 tablespoon of crushed needles, and steep for 10-15 minutes.  Drink one cup twice per day.
• Plantain infusion, 1/2 cup fresh or 1/2 teaspoon dried leaves steeped for 10-15 minutes, 3 times per day
• Goldenrod tea with 1-2 tablespoons of vinegar

For further reading:
Survival and Austere Medicine, 3rd Edition, pp 140-42.
The Survival Medicine Handbook, pp 179-81.