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Review
. 2025 Mar 17;80(3):e31-e42.
doi: 10.1093/cid/ciae653.

State-of-the-Art Review: Recurrent Uncomplicated Urinary Tract Infections in Women

Sonali D Advani  1 , Joshua T Thaden  1 , Reinaldo Perez  1 , Sabrina L Stair  2 , Una J Lee  2 , Nazema Y Siddiqui  3
Affiliations
Review

State-of-the-Art Review: Recurrent Uncomplicated Urinary Tract Infections in Women

Sonali D Advani et al. Clin Infect Dis. .

Abstract

Over 50% of adult women experience at least 1 urinary tract infection (UTI) in their lifetime, and almost one-quarter of them will experience a recurrent UTI (rUTI). Recurrent UTI is defined as ≥2 UTIs in a 6-month period or ≥3 UTIs in 12 months (at least 1 of these episodes should be culture-proven to confirm infectious etiology). In this narrative review, we discuss the epidemiology, pathogenesis, diagnosis, and treatment considerations for recurrent uncomplicated cystitis in the adult female population. We provide a focused overview of the comprehensive management of these patients, with input from infectious disease physicians, urogynecologists, and urologists with expertise in rUTI, highlighting updated recommendations by the Infectious Diseases Society of America, American Urologic Association, Canadian Urologic Association, and American Urogynecologic Society. Finally, given the variety of prevention strategies, different treatment goals, and the need for "preference sensitive" decisions, we highlight the need for shared decision-making with patients.

Keywords: LUTS; asymptomatic bacteriuria; chronic UTI; recurrent UTI; recurrent cystitis.

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Conflict of interest statement

Potential conflicts of interest. Dr Advani reports support from Centers for Disease Control and Prevention (SHEPheRD 75D30121D12733-D5-E003 and 5U54CK000616-02), the Society for Healthcare Epidemiology of America, and the Duke Claude D. Pepper Older Americans Independence Center (National Institute on Aging grant no. P30AG028716), as well as past consulting fees from Locus Biosciences, Sysmex America, GlaxoSmithKline, bioMérieux, and the Infectious Diseases Society of America. Dr. Advani became an employee of GSK/ViiV Healthcare after submission of this manuscript. Dr. Siddiqui reports ongoing research support from Medtronic, Inc. and Ethicon Johnson & Johnson, consulting fees from Boston Scientific, royalties from UpToDate, and serves on the Board of Directors for the American Urogynecologic Society. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

References

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