Infectious Disease Referrals Optimize Long-term Management of Women With Recurrent Urinary Tract Infections

To evaluate the role of Infectious Disease (ID) specialists in the long-term management strategies of referred patients with recurrent urinary tract infections (rUTIs).

Following IRB approval, a retrospective chart review was conducted on eligible adult female patients with uncomplicated treatment-refractory rUTIs referred from the Urology clinic to the ID clinic. Descriptive statistics were used to summarize demographic and clinical data, and McNemar's test was used for paired binary comparisons.

From January 2017 to December 2023, 62 of 111 patients met study criteria. Median age was 76 years and 82% were postmenopausal. The median interval from initial Urology visit to ID referral was 2.5 years. Escherichia coli was the most frequently isolated organism, with polymicrobial cultures in 58%. Median follow-up with ID was 4.3 years. Continuous antibiotic suppression was more common in patients seen in the ID clinic (71% vs 53%), and intravenous antibiotics were used exclusively by ID (4%). Hospitalizations related to UTI decreased from 37% to 24% following the establishment of care with ID (P = .088). Vaginal estrogen was prescribed at referral in 52% of postmenopausal women.

Involvement of ID in patients with treatment-refractory rUTI was associated with more individualized antimicrobial management and antibiotic stewardship, with a nonsignificant trend toward fewer hospitalizations in a tertiary care setting.