Can recurrent UTIs in women be cured? Review article

Uncomplicated urinary tract infection (UTI) is common, resulting in a wide range of expenses and disturbing quality of life, especially in women.

Clinicians should take patients’ complete history and physical examination to determine the cause of recurrent UTI, and should consider further investigation in patients who are suspected of having complicated UTI. A urine culture is mandatory for recurrent UTI in every episode of symptomatic infection, before starting treatment. The antibiotic can be nitrofurantoin, TMP-SFX, or fosfomycin, for no longer than 7 days, to treat episodic uncomplicated infection patients. Post-coital prophylaxis show efficacy for recurrent UTI associated with sexual activity in premenopausal women. Non-antibiotic prophylaxis and low dose antibiotic prophylaxis can be used for patients who have frequent recurrent UTIs. Vaginal estrogen has efficacy to treat recurrent UTIs for post-menopausal women. Good hygiene is generally advised, despite limited data to support it. The vaccine for recurrent cystitis has opened a new door for the treatment of women with recurrent cystitis, however, long tern data are needed to confirm the efficacy.