Most of us know the tell-tale symptoms that can signal a urinary tract infection (UTI) – the need to urinate frequently, burning, or cloudy urine. But these symptoms are not unique to UTIs and can also be associated with having high bacteria levels in the bladder when no infection has actually developed. So it’s important for your healthcare provider to run a urine culture to confirm a UTI, especially before prescribing an antibiotic.
Urinalysis vs. Urine Culture
Let's talk about the difference between a urinalysis and a urine culture, tests for confirming if you actually have a UTI. They are often confused as both involve providing a urine sample, but the latter is more comprehensive and is a MUST when it comes to diagnosing a true UTI.
A urinalysis, more commonly known as a dipstick urinalysis (a plastic strip treated with chemicals and dipped into a urine sample), is a quick visual look at the urine. It can identify blood, acidity and pH level, and white blood cell count. While a urinalysis is usually the first thing a healthcare provider suggests if you share that you have symptoms, it is NOT a confirmation of an infection as it does NOT determine what
types of bacteria are in the urine and if there is a high enough amount to signal an actual infection, regardless of your symptoms. Like the rest of our bodies, our urine normally contains small amounts of bacteria, but these bacteria usually do not colonize to cause an infection. (We’ll talk about colonization in a moment!)
Most urological specialists agree that treatment for a UTI should not be initiated based upon urinalysis alone. This is where the urine culture comes in.
A urine culture is a much more comprehensive test, the gold standard for diagnosing a UTI. A urine sample is sent out to a specialized lab for evaluation where it is tested to determine if the bacteria and other organisms multiply (known as colonization) and infect the bladder. It can take up to 72 hours for the results to come back. Most healthcare providers are (or should be) waiting for the results of a urine culture before prescribing an antibiotic. Don’t worry, ask for a symptom relief product in the meantime while you await the results!
Positive and Negative Cultures
Bacterial growth at a certain level leads to a positive culture – meaning yes you have a UTI and an antibiotic is definitely needed. The culture also identifies what bacteria is the culprit of the infection so that the right antibiotic is prescribed to treat the infection. Antibiotics are not “one bacteria fits all”!
If the urine culture is negative, an antibiotic is not your best option and should not be prescribed. Symptoms experienced with negative urine cultures will not be resolved by antibiotics, and unnecessary treatment can contribute to antibiotic resistance in the future. (Note: The new national survey UTIs: The Burning Truth by ellura revealed 4 out of 5 women have experienced antibiotic side effects, including resistance!) Healthcare providers are trying to ensure that when you truly need antibiotics, they work for you.
Instead, if your urine culture comes back negative, turn to pain-relieving options to alleviate your discomfort, like pyridium (it’s available over-the-counter). These can ease feelings of burning or itching. Your healthcare provider can also discuss lifestyle changes to ease bladder pain, instead of prescribing unnecessary antibiotics. If your cultures constantly come back negative, then there are other issues that may be causing symptoms, like interstitial cystitis or painful bladder syndrome.
"Without a culture, I stress to the patient, I cannot give them an antibiotic,” noted urologist, Dr. Nazia Bandukwala.
Think you have a UTI? Demand a culture before opting for antibiotics.
Save them for when you truly need them -- to treat an infection.