How is acute uncomplicated UTI prevented?
Prophylactic antimicrobial therapy given as a long-term, low-dose regimen or as a single dose postintercourse prevents up to 95% of episodes of recurrent cystitis. This approach is recommended for women who experience frequent reinfections, usually defined as two infections within 6 months or three infections within 1 year. Patient self-treatment with a 3-day course of TMP/SMX, norfloxacin, or ciprofloxacin is also effective. This is a useful approach for the management of women who are concerned about developing infection while traveling, or who experience severe but less frequent episodes.
Women with recurrent urinary infection should be advised not to use spermicides. Other behavioral interventions, such as changing their type of underwear, showering rather than bathing, postintercourse voiding, and postvoiding hygiene, are not helpful. The use of probiotics, including yogurt, to reestablish normal vaginal flora is not effective. Daily cranberry tablets or juice have limited, if any, efficacy in decreasing the frequency of recurrent symptomatic infection. The role of topical vaginal estrogen to prevent recurrent infection in postmenopausal women requires further evaluation; vaginal estrogen is not currently recommended solely for the prevention of recurrent urinary infection.
