Medical College of Wisconsin
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Recurrent urinary tract infections in women. Int Urogynecol J 2015 Jun;26(6):795-804

Date

11/21/2014

Pubmed ID

25410372

DOI

10.1007/s00192-014-2569-5

Scopus ID

2-s2.0-84929839148 (requires institutional sign-in at Scopus site)   127 Citations

Abstract

INTRODUCTION AND HYPOTHESIS: Recurrent urinary tract infections (UTIs) are more common in women and are frequently defined as ≥2 episodes in the last 6 months or ≥3 episodes in the last 12 months. In a primary care setting, 53 % of women above the age of 55 years and 36 % of younger women report a recurrence within 1 year. Thus, management and prevention of recurrent UTI is of utmost significance. This review aims to highlight the latest research in prevention strategies and suggest a management pathway.

METHODS: A search was conducted on MEDLINE, Embase and the Cochrane Database of Systematic Reviews databases for the latest systematic reviews and high-quality randomized controlled trials. Special emphasis was placed on the remit "recurrent" and strongly adhered to. Furthermore, a Google search was conducted for current guidelines on the management of UTIs.

RESULTS: Current prevention strategies include eliminating risk factors that increase the risk of acquiring recurrent UTI and continuous, post-coital and self-initiated antimicrobial prophylaxis. Other prospective preventative strategies, currently under trial, include use of vaccinations, D-mannose and lactobacillus (probiotics).

CONCLUSION: Although risk factors should be identified and addressed accordingly, individualized antibiotic prophylaxis remains the most effective method of management. Non-antibiotic prevention strategies such as cranberry, vitamin C and methenamine salts lack strong evidence to be introduced as routine management options and as alternatives to antibiotics. Based on current evidence and guidelines, a management pathway is recommended. Emerging therapies require further evaluation before they can be recommended.

Author List

Aydin A, Ahmed K, Zaman I, Khan MS, Dasgupta P

Author

Iftikhar Zaman MBChB Assistant Professor in the Radiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Antibiotic Prophylaxis
Coitus
Female
Humans
Life Style
Recurrence
Risk Factors
Urinalysis
Urinary Tract Infections