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Recurrent Urinary Tract Infections in Adult Women

Educational Objective
To understand how to diagnose and treat Recurrent Urinary Tract Infections in women
1 Credit CME

Urinary tract infections (UTIs) disproportionately affect adult women. Postmenopausal women are especially vulnerable to recurrent UTI, commonly defined as culture-proven UTIs that have occurred at least twice within 6 months or 3 times within 12 months. Current prevalence estimates are lacking, despite the significant negative effect of recurrent UTI on quality of life and health care costs.1 There is significant variation in patient care related to inconsistent recommendations from key professional societies due to lack of high-quality evidence supporting clinical guidelines.25

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Article Information

Corresponding Author: Linda Brubaker, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, 9500 Gilman Dr, MC 0971, La Jolla, CA 92075 (librubaker@ucsd.edu).

Published Online: January 29, 2020. doi:10.1001/jama.2019.21377

Conflict of Interest Disclosures: Dr Aslam reported receiving personal fees as a consultant from Merck. Dr Brubaker reported receiving grants from the National Institutes of Health and editorial stipends from Female Pelvic Medicine & Reconstructive Surgery and UpToDate. No other disclosures were reported.

References
1.
Wagenlehner  F, Wullt  B, Ballarini  S, Zingg  D, Naber  KG.  Social and economic burden of recurrent urinary tract infections and quality of life: a patient web-based study (GESPRIT).  Expert Rev Pharmacoecon Outcomes Res. 2018;18(1):107-117.PubMedGoogle ScholarCrossref
2.
Nicolle  LE, Gupta  K, Bradley  SF,  et al.  Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America.  Clin Infect Dis. 2019;68(10):1611-1615. doi:10.1093/cid/ciz021PubMedGoogle ScholarCrossref
3.
Brubaker  L, Carberry  C, Nardos  R, Carter-Brooks  C, Lowder  JL.  American Urogynecologic Society best-practice statement: recurrent urinary tract infection in adult women.  Female Pelvic Med Reconstr Surg. 2018;24(5):321-335.PubMedGoogle ScholarCrossref
4.
Anger  J, Lee  U, Ackerman  AL,  et al.  Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline.  J Urol. 2019;202(2):282-289. doi:10.1097/JU.0000000000000296PubMedGoogle ScholarCrossref
5.
Dason  S, Dason  JT, Kapoor  A.  Guidelines for the diagnosis and management of recurrent urinary tract infection in women.  Can Urol Assoc J. 2011;5(5):316-322. doi:10.5489/cuaj.687PubMedGoogle ScholarCrossref
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