title: Consensus document of the Spanish Urological Association on the management of uncomplicated recurrent urinary tract infections.
abstract: BACKGROUND
  The clinical manifestations of urinary infections, commonly mild and uncomplicated, have resulted in a generally empirical therapeutic decision-making process, which does not help fight resistances to antibacterial agents, thus causing a high rate of recurrence.
  
  
  OBJECTIVE
  This study seeks to reduce the clinical variability in the diagnosis and treatment of uncomplicated recurrent urinary tract infections (RUTIs).
  
  
  METHODS
  The consensus document was developed using a nominal group methodology, using scientific evidence on RUTIs extracted from a systematic (noncomprehensive) literature review, along with the expert judgment of specialists and their experience in clinical practice.
  
  
  RESULTS
  RUTIs are considered the manifestation of at least 3 episodes of uncomplicated infection, with a positive culture in the past 12 months, in addition to (for men) the absence of structural or functional abnormalities. We maintain that the treatment should be empiric when suspecting RUTIs (prior to obtaining a urine sample for culture) in those patients who have a high probability of recurrence, associated risk factors and/or urinary or general symptoms, such as fever and chills. Homogeneous criteria are recommended for the diagnosis and treatment in order to fight the increased rates of resistance that the microorganisms develop against antimicrobial agents.
  
  
  CONCLUSIONS
  Imprecision in the identification of the infection requires a search for agreements on homogenized criteria and decision algorithms that guide the management of these patients.
authors.affiliation: Servicio de Urología, Hospital Universitario de Elche, Alicante, España. Electronic address: prieto_lui@gva.es.
authors.forename: L
authors.initials: L
authors.lastname: Prieto
authors.affiliation: Servicio de Urología, Hospital Nacional de Parapléjicos de Toledo, Toledo, España.
authors.forename: M
authors.initials: M
authors.lastname: Esteban
authors.affiliation: Servicio de Urología, Hospital Clínico San Carlos, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Salinas
authors.affiliation: Servicio de Urología, Hospital General Universitario, Burgos, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Adot
authors.affiliation: Servicio de Urología, Hospital Universitari i Politècnic la Fe, Valencia, España.
authors.forename: S
authors.initials: S
authors.lastname: Arlandis
authors.affiliation: Servicio de Urología, Hospital Clínico de Barcelona, Barcelona, España.
authors.forename: L
authors.initials: L
authors.lastname: Peri
authors.affiliation: Servicio de Urología, Hospital Virgen de las Nieves, Granada, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Cozar
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000175:diagnosis; D055499:Catheter-Related Infections / Q000209:etiology; D003556:Cystitis / Q000175:diagnosis / Q000188:drug therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D006920:Hygiene; D008297:Male; D010353:Patient Education as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012008:Recurrence; D012017:Referral and Consultation; D013030:Spain; D016482:Urinalysis; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy; D014563:Urodynamics
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacteriuria; Consenso; Consensus; Infección del tracto urinario; Managing disease; Manejo enfermedad; Recurrence; Recurrencia; Urinary tract infection