What is a urinary tract infection (UTI)?
UTIs rank among the infections women get most. The usual culprit is E. coli from the digestive tract, which gets into the urethra and then multiplies in the bladder. Expect pain or burning as you urinate, frequent urgent trips, a small amount each time, pressure low in your belly, and cloudy or strong-smelling urine. A shorter urethra is why women get them far more often than men. A short antibiotic course, usually 3 to 5 days, clears up most uncomplicated bladder infections quickly. Read more about UTI symptoms.
How online UTI prescriptions work
The secure assessment covers what you feel, what you are allergic to, what you take, whether you could be pregnant, any past UTIs and your pharmacy. A California-licensed physician reads all of it and may write back for more detail. If this looks like an uncomplicated bladder infection and your answers are free of safety concerns, your physician can e-prescribe to that pharmacy, usually for pickup the same day.
No antibiotic goes out automatically. Your physician may point you to in-person care or testing instead if your answers suggest pregnancy, recurrent UTIs, a medication allergy, a possible sexually transmitted infection, an unclear diagnosis, another complication, or a kidney infection (fever, chills, back or flank pain).
Pharmacy pickup
Physician-reviewed
Full refund if not prescribed
How often does E. coli resist Bactrim in Southern California?
One of the largest local answers comes from Kaiser Permanente Southern California. Researchers reviewed 233,974 E. coli samples from 174,185 outpatients with uncomplicated UTIs, 92 percent of them female, seen from 2016 to 2021, and published the results in Open Forum Infectious Diseases in 2023. Resistance to Bactrim (trimethoprim-sulfamethoxazole) showed up in 25 percent of samples, and resistance to nitrofurantoin in under 1 percent. Patterns did not differ between virtual and in-person care. These are one health system's numbers, and they may not match your town or your infection. Your physician weighs findings like these with your allergies and past treatment when choosing an antibiotic.
When online UTI treatment is appropriate
The best candidates are adult women with classic signs of an uncomplicated bladder infection, such as burning with urination, frequency, urgency, or pressure in the lower belly. If you have had a UTI and recognize this one, telehealth tends to be an especially good fit.
Other conditions, sexually transmitted infections among them, can feel much the same, which is why your physician reads your whole intake before deciding on antibiotics. Still unsure? Run our free UTI symptom checker or compare how a UTI differs from BV and a yeast infection.
When to see a doctor in person
Some urinary symptoms need an exam room, so go in person if you have any of these.
- You have fever, chills, nausea and vomiting, or back or flank pain, all possible signs of a kidney infection
- You are pregnant, you may have caught a sexually transmitted infection, or your diagnosis is new or uncertain
- Your UTIs recur, or a couple of days on antibiotics bring no improvement
See the warning signs of a serious UTI →
First-line antibiotics for a UTI
Three drugs lead the list for an uncomplicated UTI: nitrofurantoin (Macrobid), trimethoprim-sulfamethoxazole (Bactrim) and fosfomycin (Monurol). Both the IDSA uncomplicated-cystitis guideline and CDC guidance back that list. With nitrofurantoin, you would typically take 100 mg twice daily for five days. With Bactrim, the usual plan is one double-strength tablet twice daily for three days where local resistance is low. With fosfomycin, it is a single 3 g dose of granules in water. Your physician settles on the drug and how long you take it after weighing your symptoms, allergies, kidney function, pregnancy status and past treatment.
Nausea or an upset stomach can happen and is usually mild. Speak up about any antibiotic allergy, especially sulfa, which rules out Bactrim. Speak up about kidney trouble as well, because nitrofurantoin is avoided with reduced kidney function. It is also avoided near full-term pregnancy. Stay on the full course even after the burning stops. See our full guide to UTI antibiotics and treatment →
What causes a UTI in the first place?
It usually starts with bacteria from the bowel or skin reaching the urethra, then moving up to the bladder. A shorter urethra makes women more prone. Sex, a new partner, spermicide, a diaphragm, holding your urine and the changes after menopause can each raise your risk. A UTI does not count as an STI, and it does not come from poor hygiene. Drinking plenty of fluids and urinating after sex may help prevent one. Once symptoms have taken hold, though, you will usually need antibiotics. More on what causes UTIs and how to prevent them.
When UTIs keep coming back
Plenty of women hit the recurrent mark, which usually means two or more infections in six months or three or more in a year. A fresh flare that feels like your usual uncomplicated bladder infection can often be treated online the same day by a California-licensed physician, as an acute episode. Repeats like this also deserve a closer look: perhaps a urine culture, a check of your risk factors, or a preventive (prophylactic) plan. A urologist or primary care clinician you see in person often coordinates that longer workup. Read more about recurrent UTIs →
