Each week we will aim to bring out a concise email that provides 4-5 key pieces of information addressing a specific issue in clinical therapeutics.
This week: Recurrent Urinary Tract Infections (RUTIs)
Lisa Austin, Clinical Pharmacist, Ward MM
RUTIs are common, and associated with considerable morbidity and costs. A recurrence can be a relapse of a previously treated UTI, or a reinfection with the same or different bacteria. The following table shows the traditional definition of RUTIs however, any second episode of UTI could be considered a recurrence.
- Obtain urine samples for cultures and susceptibility testing from all patients with recurrent urinary tract infection.
- The main risk factors for postmenopausal women are history of UTI before menopause, atrophic vaginitis (with altered vaginal flora), factors affecting bladder emptying, and genetic factors related to blood type.
- Men who contract a UTI are likely to have a complicated UTI, with the associated risk of recurrences. The most common cause of recurrent cystitis in men is chronic bacterial prostatitis.
- Treat reinfections as for cystitis or pyelonephritis (depending on site of reinfection), as appropriate.
Next week’s Clinical Pearl will discuss treatment of RUTIs.
Please consider these issues when preparing or interpreting RMMR reports or education sessions. Contributions of content or suggested topics are welcome and should be sent directly to firstname.lastname@example.org.