Urinary Tract Infection (UTI)

How are urinary tract infections (UTI) prevented?

Whilst UTIs can be easily treated with antibiotics, the prevention of UTIs or the avoidance of recurrent infection is equally important.

About 25% of women with acute cystitis develop recurrent UTIs. Most recurrent infections are from bacteria present in the faecal or periurethral reservoirs. Some strategies can be undertaken to reduce the risk of recurrent infections.

Lifestyle changes

• Premenopausal women are advised to increase fluid (water) intake to at least 1.5 litres per day. This is not applicable to people who have to be on fluid restriction regimes for other medical conditions such as congestive heart failure.
• Sexually active women can try to pass urine immediately after intercourse to reduce the risk of introduction of bacteria into the bladder from sex.
• Wipe yourself from front to back after using the toilet to avoid bacteria from the stool contaminating the bladder. Avoid using diaphragms and spermicides and consider other forms of contraception
• Avoid use of vaginal deodorants and douches
• Wash the genital area with water and normal soap during showers

Vaginal oestrogen replacement

Use of vaginal oestrogen cream or inserts in post-menopausal patients where applicable.

Non-antibiotic treatments

• Probiotics (oral or local)
• Cranberry products
• D-Mannose
• Methenamine
  

Prophylactic antibiotics

A once-daily dose of an appropriate antibiotic (usually taken for a minimum duration of three months) may be indicated in patients with a history of multiple episodes of UTI to minimise the risk of recurrence of infection. Postcoital antibiotics may also be considered for patients who suffer from UTIs after sexual intercourse.

Treatment of any existing structural abnormalities

If recurrent UTI occurs against a background of structural abnormalities in the urinary tract (e.g., stones, kidney cysts), consideration should be given to the treatment of these conditions to eradicate the source.

Treatment of any vaginal / lower genital tract infection

These infections may spread to the urinary tract. As such, they should be treated promptly if present.