What if antibiotic treatment does not relieve painful urination?

Burning or pain when passing urine can result from a urinary infection, irritation, stones, sexually transmitted infections, vaginal or genital inflammation, or other urinary conditions. Antibiotics help only when the cause is a susceptible bacterial infection. The medicine may also need to be changed after a clinician reviews your symptoms or urine results. Tell the clinician about frequency, urgency, blood, discharge, lower abdominal pain, back pain, fever, pregnancy, and any recent sexual contact. Avoid assuming that persistent burning has one cause.

Take the prescribed antibiotic as directed and contact the prescriber if pain is not improving, gets worse, or returns. Do not use leftover antibiotics or delay review by taking someone else’s medicine. Drink fluids normally if you are able, but do not force large amounts if a clinician has restricted your fluids. Avoid products that irritate the area, and ask before using urinary pain remedies. A clinician may request a urine sample, examine the genital area, or consider another source of symptoms.

Seek urgent care for fever with pain in the side or back, vomiting, shaking chills, confusion, fainting, or feeling severely unwell. Visible blood in the urine, inability to pass urine, severe pain, or rapidly worsening symptoms also need prompt assessment. Pregnancy, a catheter, kidney disease, or a weakened immune system lowers the threshold for seeking advice.

Ask: Do I need a urine test or culture? Could this be irritation, a stone, or another infection? Should my antibiotic change? Which pain relief is safe for me? What symptoms suggest the infection has reached the kidneys?