OTCUTI testsclaim they can easily and quickly detect a urine infection. But are they accurate? Unfortunately, the research behind the OTCUTI test is not bulletproof.
Although they are called UTI test strips, they were not created to detect a urine infection if you already have symptoms. In fact, if you have the classic burning, pain, and urgency, a UTI testing strip was not made for you. Surprisingly, this is because these UTI testing strips are screening tests, not diagnostics tests. To understand this let’s take a quick look at the difference between the two tests and how they are used.
Screening tests are for patients without symptoms
A screening test is exactly what it sounds like: it screens people for a disease. The caveat here is that it looks for disease in people who have no symptoms – think of mammogram screening for breast cancer.
Let’s look at that in action. A screening test, like an OTC UTI test strip, could screen pregnant women for a UTI. They are perfect screening candidates because while most pregnant women have no symptoms, it’s really important to catch a urine infection early as they can cause problems for both mom and a baby.
A screening test is very sensitive, meaning that if the test is negative, you can be confident you don’t have the disease. OTC UTI test stripis good at ruling out a disease. So, if a pregnant woman without any burning or urgency has a negative screening test, she can be pretty sure she does not have a UTI.
Diagnostic tests confirm diagnose in the patients with symptoms
A diagnostic test diagnoses people who are very likely to have the disease because they have common symptoms.
For example, a diagnostic test is perfect for a woman who has some classic symptoms of a UTI: goes to the bathroom 15 times a day, and has pain with urination.She could use an OTC UTI test strip, but the result will be less accurate.
OTC UTI test strip does not rule in disease. For that, you need a diagnostic test. Diagnostic tests are specific, if they are negative, you can be sure you don’t have the disease.
Soif you already have UTI-like symptoms, you want to rule all other reasons before starting a treatment for UTI. For example, if you think you have a UTI when in fact you have a kidney stone, you waste precious time and resources taking antibiotics or herbal remedies that will do nothing to get rid of the stone. Diagnostic tests shine at weeding out all the people who are likely to have a disease but don’t.
Should I drink cranberry juice for UTI?
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An OTC UTI test strip is pretty accurate if it is used for screening.The problem with the results arises when you use an over-the-counter UTI test strip to diagnose a UTI.
If you have UTI-like symptoms and rely on the test, you’re asking it to do something it was never meant to do.In fact, screening tests tend to “underdiagnose” if you have symptoms. That’s because a symptomatic person is at such a high risk for the disease that a screening test can miss them.
On the other hand, if you use an OTC UTI test in a group of people who have no symptoms, it will do much better to identify patients with bacterial overgrowth.
This is why UTI test’s “sensitivity” can change from 56% to 92% depending on who is being tested.
Research shows that the role of these tests should be to screen patients without any symptoms. The marketing ploys for over-the-counter UTI strips generally fail to mention this important fact.
OTC UTI test looks for indirect evidence of an infection. Instead of spying on the E. coli swimming around in your urine, it uses enzymatic tests that can be present if you have UTI causing bacteria in your urine.
Two common tests are the Greiss test, which checks to see if nitrate is reduced to nitrite, and the leukocyte esterase test, which is a marker for inflammatory cells (white blood cells) in your urine.
When these two tests are combined, researchers conclude that this combination is not good enough to be a screening test for UTIs.Unfortunately, this is the exact combination used in many over-the-counter UTI tests.
There are several cases when an OTC UTI test could tell you that you have a UTI when you really don’t.
For example, if you have protein in your urine (kidney disease can cause this), use Vitamin C supplements or just used Azo, the leukocyte esterase test will be positive, even if you don’t have a UTI.
The Greiss test is only accurate for some bacteria, like E. coli. While most people with a UTI have E. coli, there are many have other bacteria. These folks would get a negative result on the over-the-counter UTI test when they really do have a UTI.
No, it’s not.
Despite the claims of over-the-counter UTI testing strip companies, it is not the same test your doctor uses. Rather it is a truncated version of your doctor’s test, that ignores important information about your urine.
For example, the urine test your doctor uses checks for more evidence of urine infection. It looks at the important factors that increase the sensitivity of the test and may suggest other reasons for your urinary symptoms:
- Your urine pH
- Endothelial cells
- Blood in the urine
If you’ve had UTIs before, you are well aware of the symptoms. Rather than buy UTI tests strips that are inaccurate, choose a better method.
You can choose to treat based on symptoms (with antibiotics or herbal alternatives) as long as you know the red flags (like fevers, back pain, vomiting) that mean you need to check in with your doctor.
If you have UTI symptoms and must know for sure if it really is a UTI, choose a diagnostic test instead. The most widely available diagnostic test is a microscopic urinalysis and urine culture.
Generally, we look at your urine under a microscope (to look directly for bacteria, fungi, white blood cells, red blood cells and endothelial cells). Simply adding the urinalysis increases the sensitivity of urine testing to 96%.Then, we place the urine into a petri dish with bacteria-friendly growth medium and wait for the bacteria to grow.
However, the standard urine culture test, even coupled with microscopy might not be enough. If your UTIs persist while your culture comes back negative, you might want to try a DNA-based urine test (here are the locations and prices).
- If you have recurring UTIs, ask your doctor for a standing order for a UTI test at a laboratory near you. Then simply let your doctor know each time you drop off a sample.
- You should use a cup provided by your physician to collect a sample (follow the recommendations above) and should store it in a fridge if it’s going to take you more than an hour to drop it off.
- If you’ve had a lot of “negative urine samples,” ask if your urine can be cultured for more than the standard 48 hours. A little-known fact: you can ask to have your urine kept for up to seven days, which is more likely to show a rare UTI causing bacteria.
- If you’ve had a lot of symptoms, ask your doctor to take seriously any bacteria that show up in your sample. When two or more bacteria are found, they are often labeled as “contamination” because the standard thinking is a single type of bacteria causes a UTI. However, if you have symptoms, several bacteria may be working together to cause your urine infection.
- Some women get UTIs with “less” bacteria than doctors consider significant. Normally, UTI is diagnosed with at least 100, 000 colony forming units (CFU) per milliliter of bacteria. However, if you have symptoms, fewer bacteria could be causing your symptoms (Schaeffer, 2010). Ask your doctor if any bacteria grew, even if it is a small amount.
The process is similar to getting a urine test done at your doctor’s office:
- You will need to do a mid-catch urine: you place the strip into the urine stream a few seconds after you’ve already started urinating. This decreases the risk of contamination from the vagina or urethra.
- It is also important to clean your labia (or the tip of the penis) before doing the test.
With a little know-how, you can make sure you are getting the right diagnosis. Have you tried an over-the-counter UTI test kit? What was your experience?
References:
- Fihn SD. Clinical practice. Acute uncomplicated urinary tract infection in women. N Engl J Med 2003;349:259–66.
- Kass EH. Asymptomatic infections of the urinary tract. Trans Assoc Am Phys 1956; 69:56-63.
- Pezzlo M. Detection of urinary tract infections by rapid methods. Clin Microbiol Rev 1988;1:268–80.
- Pfaller M, Koontz F. Laboratory evaluation of leukocyte esterase and nitrite tests for the detection of bacteriuria. J. Clin. Microbiol. May 1985; 21(5): 840-842.
- Recurrent uncomplicated cystitis in women: allowing patients to self-initiate antibiotic therapy. Prescrire Int. 2014 Feb;23(146):47-9.
- Ruf M, Morgan D, Mackenzie K. Differences between screening and diagnostic tests and case findings. Retrieved at: https://www.healthknowledge.org.uk/public-health-textbook/disease-causation-diagnostic/2c-diagnosis-screening/screening-diagnostic-case-finding
- Sanford JP, Favour CB, Mao FH, et al. Evaluation of the positive urine culture; an approach to the differentiation of significant bacteria from contaminants. Am J Med 1956;20:88–93.
- Schaeffer A, Matulewicz R, Klumpp D. Infections of the Urinary Tract. In Wein A, Kavoussi L, Partin A, Peters C (Ed.) Campbell- Walsh Urology (10th ed). Philadelphia, PA: W.B. Saunders, 2011
- Semeniuk H, Church D. Evaluation of the leukocyte esterase and nitrite urine dipstick screening tests for the detection of bacteriuria in women with suspected uncomplicated urinary tract infections. J Clin Microbiol 1999; 37:3051–2.
- Simerville J, Maxted W, Pahira J. Urinalysis: a comprehensive review. Am Fam Physician. 2005 Mar 15;71(6):1153-62.
- Taneja N, Chatterjee S, Singh M et al. Validity of quantitative unspun urine microscopy, dipstick test leucocyte esterase and nitrite tests in rapidly diagnosing urinary tract infections. J Assoc Physicians India. 2010 Aug;58:485-7.
FAQs
# Truth About Your OTC UTI Test. Is It Really Inaccurate? - Stop UTI Forever? ›
But are they accurate? Unfortunately, the research behind the OTC UTI test is not bulletproof. Although they are called UTI test strips, they were not created to detect a urine infection if you already have symptoms. In fact, if you have the classic burning, pain, and urgency, a UTI testing strip was not made for you.
How reliable are OTC UTI tests? ›At-home tests are not as accurate as many laboratory tests, and even people who have a symptomatic UTI may still test negative on a dipstick test. Requires follow-up: Talking to your doctor and taking follow-up tests may be needed regardless of your at-home UTI test result.
Can a UTI urine test be wrong? ›Background: Voided urinalysis to test for urinary tract infection (UTI) is prone to false-positive results for a number of reasons. Specimens are often collected at triage from women with any abdominal complaint, creating a low UTI prevalence population.
What is the most sensitive test for UTI? ›The two most common tests to detect UTIs are a urinalysis and a urine culture with antimicrobial susceptibility testing: Urinalysis: A urinalysis is a group of physical, chemical, and microscopic tests on a sample of urine. These tests look for evidence of infection, such as bacteria and white blood cells.
Should I take an at home UTI test? ›Home test kits might be useful if you have UTIs that keep coming back. They check for white blood cells and bacteria in the urine. But the results can be affected by a number of things, like medications you're taking. And studies show that urine cultures are far more reliable for showing whether you have a UTI.
Why do I feel like I have a UTI but the test is negative? ›If your urine culture shows you don't have a UTI, you'll need further testing to find out the cause of your symptoms.” In rare cases, a person with symptoms similar to a UTI, but with repeated negative cultures (meaning they don't show a bacterial infection) may in fact have bladder cancer.
Can you have leukocytes in urine but no infection? ›It is also possible to have leukocytes in urine and suffer symptoms of bacterial infection without such infection being demonstrated. This means that even if a patient has symptoms, no bacteria will be found in the sediment or culture. This phenomenon is called sterile leukocyturia.
Can you test negative for a UTI and still have one? ›Let's just put it out there that if you have received negative results for a urine culture, but you still have symptoms, it is very possible you have a UTI. Unfortunately, these testing issues can add another layer of confusion and uncertainty when seeking answers.
What else could it be if not a UTI? ›Interstitial Cystitis (IC) or Bladder Pain Syndrome (BPS) or IC/BPS is an issue of long-term bladder pain. It may feel like a bladder or urinary tract infection, but it's not. It is a feeling of discomfort and pressure in the bladder area that lasts for six weeks or more with no infection or other clear cause.
Can you have a negative urine culture and still have a UTI? ›Almost all women who exhibited symptoms of a urinary tract infection, but had a negative urine culture, actually had an infection, a small Belgian study found.
What is the gold standard for UTI testing? ›
SUC is one of the most widely used diagnostic tests in healthcare and is currently considered the gold standard for diagnosing UTIs [5].
What is the gold standard test for urinary tract infection? ›Urine culture is the gold standard for detection of urinary tract infection. However, asymptomatic bacteriuria is common, particularly in older women, and should not be treated with antibiotics.
Can you get rid of a UTI without antibiotics? ›Simple bladder infections may go away on their own in about a week — even without antibiotics. If you don't have any symptoms of a kidney infection and you aren't pregnant or at high risk of developing complicated UTI, you may opt for a “wait-and-see” approach to antibiotic treatment.
How do you tell if you have a UTI without a test? ›- Pain or burning during urination (dysuria)
- Frequent and urgent urination.
- Pain in the pelvic area.
- Waking at night to urinate (nocturia)
- Blood in the urine (hematuria)
Pain or burning while urinating. Frequent urination. Feeling the need to urinate despite having an empty bladder. Bloody urine.
Can azo get rid of UTI? ›No, AZO Urinary Tract Defense does not cure a urinary tract infection. Its purpose is to keep you comfortable and to control the infection until you can see your primary care provider. Your doctor will prescribe an antibiotic medication capable of eliminating the bacteria responsible for the infection.
What mimics a UTI but isn t? ›Painful Bladder Syndrome (PBS)
PBS is not caused by an infection, but it can feel like a urinary tract infection or UTI. Painful bladder syndrome is also referred to as bladder pain syndrome and interstitial cystitis.
Hemoglobinuria, myoglobinuria, menstrual blood, concentrated urine, and strenuous exercise can cause a false-positive result on a dipstick test (4). A pH<5.1 and increased urinary density may result in false-negative reactions on the strip (4).
How to get rid of leukocytes in urine without antibiotics? ›Lifestyle changes can help reduce the symptoms of some conditions that cause leukocytes to enter the urine. These include: drinking more water. urinating when you have to go.
Does positive leukocytes always mean UTI? ›Leukocyte esterase is a screening test used to detect a substance that suggests there are white blood cells in the urine. This may mean you have a urinary tract infection. If this test is positive, the urine should be examined under a microscope for white blood cells and other signs that point to an infection.
What does it mean when you have leukocytes in your urine for no reason? ›
An infection in your urinary tract is the most likely cause of leukocytes in your urine. Any time you have an infection, your immune system ramps up production of these cells to fight off the bacteria. More than half of women and about 1 in 5 men will get a UTI at some point in their lives.
How often are UTIs misdiagnosed? ›Urine cultures have a 5 percent false-positive rate, as some people have bacteria in their urine without experiencing any symptoms of an infection. All of those factors make urinary tract infections particularly difficult to diagnose, especially under the time constraints of the ER.
What causes false positive leukocytes in urine? ›[19] Hematuria can cause a false positive result for urine WBCs. Leukocytes and WBCs may be present in urine due to other conditions such as appendicitis, diverticulitis, sexually transmitted infection, and renal injury.
How to tell the difference between UTI and interstitial cystitis? ›The Difference Between a UTI and IC
In women who have interstitial cystitis, urine culture results will be negative, meaning that no bacteria are found in the urine as with a urinary tract infection. With IC, women may also experience pain during sexual intercourse, another symptom not commonly associated with a UTI.
Bladder infections are a type of UTI, but not all urinary tract infections are bladder infections. A UTI is defined as an infection in one or more places in the urinary tract—the ureters, kidneys, urethra, and/or bladder. A bladder infection is a UTI that's only located in the bladder.
What causes UTI if not bacteria? ›Urine can back up in the urethra, which can cause UTI s. Blockages in the urinary tract. Kidney stones or an enlarged prostate can trap urine in the bladder.
Can a urine culture miss bacteria? ›Negative urine culture: A culture reported as “no growth in 24 or 48 hours” usually indicates no evidence of infection. But if symptoms persist, a urine culture may be repeated on another sample to look for the presence of bacteria at lower colony counts or other microorganisms that can cause symptoms.
How can I test for UTI at home? ›You can buy a home urinary tract infection (UTI) test kit. They are available without a prescription at a drugstore or online. The home test kit contains specially treated test strips. You hold them in your urine stream or dip them in a sample of your urine.
How accurate is urine culture sensitivity? ›For urine culture, sensitivity varies from 50 to 95%, depending on threshold for UTI, and specificity varies from 85-99%. Urine culture is not recommended to diagnose or verify uncomplicated UTI because the sensitivity of urine culture is limited and the required delay for results.
Can you have UTI without nitrites? ›If there are nitrites in your urine, it may mean that you have a UTI. But, even if no nitrites are found, you may still have an infection. That's because some types of bacteria don't change nitrates into nitrites.
What is the difference between urine culture and urinalysis? ›
What's the difference between urinalysis and a urine culture? A urine culture involves growing bacteria from a urine sample in a lab to diagnose urinary tract infections and other infections. Urine cultures are not part of routine urinalysis tests.
What color should UTI test be? ›It is used as an aid in the screening of urinary tract infection (UTI). The test is a firm plastic strip onto which Leukocyte and Nitrite test pads are attached. If the test is positive, the Leukocyte test pad should be beige to dark purple, and the Nitrite test pad should be uniform pink to red.
How did they treat UTIs before antibiotics? ›Management included hospitalization, bed rest, attention to diet, plasters, narcotics, herbal enemas and douches, judicious bleeding (direct bleeding, cupping and leeches), and surgery for stones, abscess and retention.
What is the strongest natural antibiotic for UTI? ›Cranberry juice is one of the most well-established natural treatments for UTIs. People also use it to clear other infections and speed wound recovery. 2020 research into the effectiveness of cranberries for UTIs has found it to be effective.
Can I fight off a UTI without a doctor? ›Over-the-counter UTI medication can help relieve pain and UTI symptoms but won't treat or cure the UTI. A UTI needs to be treated with antibiotics to prevent serious health complications. Antibiotics are the only medication that can cure a UTI.
What sleeping position is best for UTI? ›Best UTI Sleeping Position? The most comfortable sleeping position for anybody struggling with a UTI would be any that put the least pressure on your pelvic muscles, such as the foetal position, or if you prefer sleeping on your back, spreading your legs apart.
What are the 8 most common causes of UTIs? ›- Sex. We know, huge bummer. ...
- Constipation. You might be able to blame your poop (or lack thereof) for your UTI. ...
- Uncontrolled diabetes. “When blood sugar is high, the excess sugar is removed through the urine,” Hawes says. ...
- Holding it. ...
- Dehydration. ...
- Birth control. ...
- Feminine products. ...
- Kidney stones.
In most cases, clear urine is a sign that you're well hydrated. And that's a positive thing because good hydration helps your body function at its best. But, in some cases, clear pee may mean that you're drinking too much water and you're too hydrated.
What is the most common infection before UTI? ›The most common bacteria found to cause UTIs is Escherichia coli (E. coli). Other bacteria can cause UTI, but E. coli is the culprit about 90 percent of the time.
What can trigger a UTI? ›A UTI develops when microbes enter the urinary tract and cause infection. Bacteria are the most common cause of UTIs, although fungi rarely can also infect the urinary tract. E. coli bacteria, which live in the bowel, cause most UTIs.
What does the beginning stages of a UTI feel like? ›
There are several early UTI warning signs that are quite easy to recognize. The most common UTI ailment is a feeling of a burning sensation when you start to urinate. Another common UTI symptom is having the urge to urinate more frequently, but only passing a small amount of urine at a time.
Can you flush out a UTI with water? ›“It's estimated 50 percent of UTIs can be treated by drinking a significant amount of fluid alone," says Felecia Fick, a Mayo Clinic urogynecology physician assistant who was not involved in the study. "The extra you're drinking is flushing out the bacteria that are present in the urinary tract."
Why can't you take Azo for more than 2 days? ›You shouldn't take it for more than 2 days to treat symptoms of a UTI without speaking to your healthcare provider since it can hide a worsening infection.
What happens if a UTI goes untreated for a week? ›If left untreated, a UTI can turn into a kidney infection, also called pyelonephritis. Pyelonephritis can cause serious complications, like kidney scarring, high blood pressure, and renal failure, which is why treatment is essential.
Can azo cause a false negative UTI test? ›Phenazopyridine can interfere with certain laboratory tests (including urine tests for kidney function, bilirubin, and sugar levels), possibly causing false test results. Home urine tests (including diabetic tests) may be affected. Make sure laboratory personnel and all your doctors know you use this drug.
How can I get antibiotics for a UTI without going to the doctor? ›...
Treatment options
- Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS)
- Fosfomycin (Monurol)
- Nitrofurantoin (Macrodantin, Macrobid, Furadantin)
- Cephalexin.
- Ceftriaxone.
Urinary tract infections (UTIs) are infections of the bladder, urethra, and kidney. Simple bladder infections may go away on their own in about a week — even without antibiotics.
How do you get rid of leukocytes in urine naturally? ›Lifestyle changes can help reduce the symptoms of some conditions that cause leukocytes to enter the urine. These include: drinking more water. urinating when you have to go.
Can you have a UTI without burning urine? ›Myth: All UTIs cause symptoms.
However, it is possible to have bacteria in the urinary tract but not have any UTI symptoms. This is called asymptomatic bacteriuria, and it is more common in older adults or people who use a catheter to empty their bladders.
- Frequent urination. UTIs cause a strong and persistent urge to urinate. ...
- Burning sensation when urinating. ...
- Pink or red urine. ...
- Releasing small amounts of urine. ...
- Strong smelling urine.
What is a non prescription remedy for UTI? ›
- Try cranberries. ...
- Drink plenty of water. ...
- Pee when you need to. ...
- Take probiotics. ...
- Get more vitamin C. ...
- Wear loose clothing. ...
- Consider switching birth control. ...
- Use a heating pad.
The use of probiotics, especially lactobacilli, has been considered for the prevention of UTIs. Since lactobacilli dominate the urogenital flora of healthy premenopausal women, it has been suggested that restoration of the urogenital flora, which is dominated by uropathogens, with lactobacilli may protect against UTIs.