Recurrent urinary tract infection in women: emerging concepts regarding etiology and treatment considerations

Recurrent urinary tract infections are caused by a combination of host factors and bacterial virulence. The patient with symptoms suggestive of recurrent urinary tract infections benefits from cultures to confirm the diagnosis of recurrent infections. The community also benefits because they allow for the tracking of resistant patterns. Once a patient has been diagnosed with recurrent urinary tract infections, there are a number of treatment choices in terms of initial treatment and prophylaxis. Treatment of the acute infection should follow the published guidelines of the Infectious Diseases Society of America taking into account local patterns of resistance. Younger patients can prevent infections by avoiding spermicides and taking cranberry tablets. Older patients may prevent infections by using estrogen and emptying their bladders fully. All patients may benefit from using antibiotic prophylaxis.