[Lower urinary tract infections in women. Recent data]

Area of Science:

• Urology
• Infectious Diseases
• Bacteriology

Context:

• Lower urinary tract infection (LUTI) is a prevalent condition, particularly among young women.
• While often having a favorable prognosis, LUTI can lead to significant morbidity, including social and sexual discomfort, and frequent recurrences.
• Accurate diagnosis, primarily through bacteriological examination of midstream urine, is crucial.

Purpose:

• To review current diagnostic and therapeutic strategies for lower urinary tract infections.
• To highlight the efficacy and benefits of single-dose antibiotic therapy for uncomplicated LUTI.
• To discuss management options for recurrent LUTI.

Summary:

• Bacteriological examination of midstream urine is essential for diagnosing LUTI.
• Nitrite and leucocyte esterase tests enhance the sensitivity of screening for asymptomatic bacteriuria, especially in pregnant or elderly women.
• Single-dose antibiotic therapy is as effective as conventional 5-7 day regimens for uncomplicated LUTI and offers reduced toxicity and candidiasis risk in pregnant women.
• Management of recurrent LUTI may involve continuous low-dose treatment, prophylactic therapy, or self-administered single doses, though the latter two require further clinical evaluation.

Impact:

• Single-dose therapy is established as the preferred treatment for uncomplicated LUTI.
• This approach offers improved patient compliance and reduced adverse effects, particularly in specific populations like pregnant women.
• Further research is needed to validate prophylactic and self-administered single-dose strategies for recurrent infections.