Recurrent urinary tract infections

Recurrent urinary tract infections has been defined as 3 or more episodes of urinary tract infection during a 12 month period (1).

More recent guidance defines recurrent urinary tract infections as (2):

• 2 or more symptomatic lower UTIs in six months or 3 or more symptomatic lower UTIs in one year

Urinary tract infection (UTI) is defined as (2):

• typical symptoms of infection (such as dysuria, nocturia, change in urine appearance or odour) with a clinical response to antibiotics, even in the
  absence of microbiological confirmation, or,
• typical symptoms of infection with a positive urine dipstick (positive for nitrite or leukocyte and red blood cells), or,
• typical symptoms of infection with a positive urine culture

It may be necessary for some patients to be on long-term low dose therapy in order to prevent recurrence of infection.

Trimethoprim and nitrofurantoin have been indicated for long term use in these instances.

Other factors should be considered (see linked options).

Reference:

• Dawson S et al. Guidelines for the diagnosis and management of recurrent urinary tract infection in women.Can Urol Assoc J. Oct 2011; 5(5): 316-322
• Academy of Medical Royal Colleges on behalf of the Evidence-based Interventions Programme Board (January 2024). Evidence-based Interventions
  Clinical guidance Release 4 - Urology