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Best Practices for Recurrent Urinary Tract Infections in Females

Dominique Exume, Anna Posner, Jaime B. Long

Recurrent Urinary Tract Infection (RUTI) is a common plight among adult women. The cause of RUTI is multifactorial, with many host and pathogenic features acting as risk factors for development. When a patient develops a pattern of recurrent urinary tract infections, prompt recognition allows for accurate diagnosis, appropriate treatment, and effective preventive measures. Diagnosis of RUTI requires occurrence of 2 culture-proven UTIs in 6 months, or 3 in 12 months. When RUTI is recognized, evaluation with a thorough history and examination is indicated. On occasion, other diagnostic testing is warranted. Current guidelines for treatment of acute uncomplicated cystitis propose first-line antibiotic regimens, which are applied to women with RUTI, with certain exceptions due to resistance, medical conditions, or allergies. Prevention may involve topical estrogen treatment for women in a hypo estrogenic state, antibiotic prophylaxis, or use of other antibacterial tools. Further research is ongoing to find novel strategies to prevent RUTI.