Journal
MEDICAL CLINICS OF NORTH AMERICA
Volume 97, Issue 4, Pages 737-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.mcna.2013.03.006
Keywords
Urinary tract infection; Acute cystitis; Resistance; Fosfomycin; Trimethoprim-sulfamethoxazole; Nitrofurantoin; Recurrent UTI
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Antimicrobial resistance of urinary pathogens is increasing. Most urinary tract infections (UTIs) should still be treated empirically. However, patients with recurrence or other risk factors for resistance may benefit from urine culture. Patients with recurrent UTI often resort to antibiotic prevention, a risky proposition in terms of resistance. Non-antimicrobial preventative methods should be considered first. If preventative antibiotics must be used, postcoital patient-initiated protocols are effective and reduce overall antibiotic exposure compared with continuous prophylaxis. Consider referring patients for urologic evaluation when at risk for complicated UTIs or when recurrence continues despite conservative interventions.
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