Urinary tract infections (UTIs) are among the most common health concerns for women, and Maldivian women are no exception. In fact, more than half of women will experience at least one UTI in their lifetime, and many face recurrent infections. The reason is partly due to women's anatomy - shorter urethras mean bacteria have a shorter distance to travel to reach the bladder.

But here's the alarming part: over 92% of bacteria causing UTIs are now resistant to at least one common antibiotic, and nearly 80% are resistant to two or more. This isn't just a statistic, it's a reality that's changing how we treat these all-too-common infections.

During my time as a medical officer in the Maldives, I treated a 19-year-old patient battling recurrent UTIs. When her lab results arrived, I was in disbelief. The bacteria causing her infection were resistant to most common oral antibiotics. The only effective medications were last-resort antibiotics typically reserved for critically ill patients in intensive care.

This young woman wasn't in an ICU or battling a life-threatening infection. Yet her treatment options were as limited as if she were. This is the unfortunate reality of antibiotic resistance. What should have been straightforward now required a multidisciplinary approach, specialised antibiotics, and weeks of follow-up. For her and many others, a seemingly routine UTI has become a medical challenge.

More severe symptoms: Resistant infections can lead to prolonged discomfort and pain. A few days of mild discomfort could turn into weeks of agony.

Increased risk of hospitalisation: What used to be a quick fix might now require intravenous antibiotics and a hospital stay which can be disruptive and potentially very costly.

Potential for serious complications: Untreated or resistant UTIs can spread to the kidneys or bloodstream, causing life-threatening conditions like sepsis. Antibiotic-resistant UTIs significantly increase the risk of sepsis and acute kidney injury.

Impact on reproductive health: Recurrent UTIs can affect fertility and complicate pregnancies which is a serious concern for women trying to conceive or already pregnant.

Quality of life: Chronic or recurrent UTIs can significantly impact a woman's quality of life, affecting intimate relationships and work productivity.

Recognise symptoms early: Be aware of UTI symptoms like frequent urination, burning pain, or cloudy urine. Don't dismiss these signs. Early medical intervention can prevent complications and reduce resistance risk.

Don't self-medicate: Always consult a healthcare provider before taking antibiotics for a suspected UTI. Self-diagnosis and treatment contribute to resistance. Complete the full prescribed course, even if symptoms improve early. Avoid sharing or reusing leftover antibiotics.

Report irresponsible pharmacies: If you notice pharmacies selling antibiotics without a prescription, report them to authorities. This helps enforce regulations and reduce community misuse.

Adopt healthy habits:

• Stay hydrated: Drink 6-8 glasses of water daily to flush bacteria from your urinary system.

• Practice good hygiene: Change out of wet clothing promptly after swimming. Wipe front to back after using the bathroom. Wear breathable underwear and change it frequently.

• Practice safe sex: Use condoms without spermicide to minimise infection risks. Wash with lukewarm water after sexual activity to reduce bacterial transfer.

• Maintain pH balance: Avoid scented hygiene products to help maintain natural balance and reduce UTI risk.

• Don't hold your urine: Empty your bladder as soon as you feel the urge.

Seek medical advice for recurring UTIs: If prone to frequent UTIs, consult your healthcare provider about underlying causes and long-term prevention strategies.

Spread awareness: Share information about UTI prevention and antibiotic resistance with other women in your community.

Antibiotic-resistant UTIs are not just a medical problem, they are a community challenge requiring collective action. By understanding risks, adopting preventive measures, and supporting each other, women can take meaningful steps to protect their health. Remember: your health is your most valuable asset. Stay informed, be proactive, and prioritise your well-being.