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International Urogynecology Journal
Published in: International Urogynecology Journal 6/2015

01-06-2015 | Review Article

Recurrent urinary tract infections in women

Authors: Abdullatif Aydin, Kamran Ahmed, Iftikhar Zaman, Muhammad Shamim Khan, Prokar Dasgupta

Published in: International Urogynecology Journal | Issue 6/2015

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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.
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Metadata
Title
Recurrent urinary tract infections in women
Authors
Abdullatif Aydin
Kamran Ahmed
Iftikhar Zaman
Muhammad Shamim Khan
Prokar Dasgupta
Publication date
01-06-2015
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 6/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-014-2569-5

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