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.
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