Recurrent urinary tract infections: from pathogenesis to prevention

Area of Science:

• Urology
• Infectious Diseases
• Women's Health

Background:

• Recurrent urinary tract infections (RUTIs) are highly prevalent in women.
• RUTIs cause significant patient discomfort, increase healthcare expenditures, and are a leading cause of antibiotic use.
• Current prevention strategies lack robust evidence, necessitating further research.

Purpose of the Study:

• To review and evaluate existing strategies for preventing RUTIs.
• To identify the need for high-quality, comparative studies to determine the optimal prevention method.

Main Methods:

• Review of current literature on RUTI prevention.
• Analysis of evidence supporting antibiotic prophylaxis and non-antibiotic measures.
• Identification of research gaps and the need for randomized controlled trials.

Main Results:

• Multiple prevention options exist, including antibiotic treatments (continuous or postcoital prophylaxis) and non-antibiotic interventions (e.g., vitamin D, D-mannose, probiotics, estrogen, vaccines).
• The evidence supporting these interventions varies in quality, with many studies being of poor quality.
• There is a clear need for well-designed, randomized, and comparative studies.

Conclusions:

• Effective prevention strategies for RUTIs are crucial for reducing patient burden and antibiotic consumption.
• Current evidence is insufficient to definitively recommend one prevention strategy over another.
• Further high-quality research is essential to guide clinical practice and optimize RUTI prevention.