title: Recurrent urinary tract infections in women.
abstract: OBJECTIVE
  Recurrent urinary tract infections (UTIs) are more common in women and are frequently defined as ≥2 episodes in the last 6 months or ≥3 episodes in the last 12 months. In a primary care setting, 53 % of women above the age of 55 years and 36 % of younger women report a recurrence within 1 year. Thus, management and prevention of recurrent UTI is of utmost significance. This review aims to highlight the latest research in prevention strategies and suggest a management pathway.
  
  
  METHODS
  A search was conducted on MEDLINE, Embase and the Cochrane Database of Systematic Reviews databases for the latest systematic reviews and high-quality randomized controlled trials. Special emphasis was placed on the remit "recurrent" and strongly adhered to. Furthermore, a Google search was conducted for current guidelines on the management of UTIs.
  
  
  RESULTS
  Current prevention strategies include eliminating risk factors that increase the risk of acquiring recurrent UTI and continuous, post-coital and self-initiated antimicrobial prophylaxis. Other prospective preventative strategies, currently under trial, include use of vaccinations, D-mannose and lactobacillus (probiotics).
  
  
  CONCLUSIONS
  Although risk factors should be identified and addressed accordingly, individualized antibiotic prophylaxis remains the most effective method of management. Non-antibiotic prevention strategies such as cranberry, vitamin C and methenamine salts lack strong evidence to be introduced as routine management options and as alternatives to antibiotics. Based on current evidence and guidelines, a management pathway is recommended. Emerging therapies require further evaluation before they can be recommended.
authors.affiliation: Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, MRC Centre for Transplantation, King's College London, London, UK.
authors.forename: Abdullatif
authors.initials: A
authors.lastname: Aydin
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
authors.forename: Iftikhar
authors.initials: I
authors.lastname: Zaman
authors.forename: Muhammad Shamim
authors.initials: MS
authors.lastname: Khan
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
mesh_terms: D019072:Antibiotic Prophylaxis; D003075:Coitus; D005260:Female; D006801:Humans; D008019:Life Style; D012008:Recurrence; D012307:Risk Factors; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*