Abstract

Recurrent urinary tract infections (UTIs) in women occur because of colonization of periurethral tissue with pathogenic bacteria. Factors that can increase a woman's predisposition to develop UTIs include: not voiding after intercourse, postponing micturition, and use of the diaphragm. IVPs and cystoscopy are rarely indicated for the otherwise healthy woman who has recurrent UTIs. Coagulase negative staphylococcus in a symptomatic woman may be pathogenic, and resistance to novobiocin should be determined. The acute urethral syndrome can be caused by low-count bacteriuria or by chlamydia. Single-dose therapy for uncomplicated UTIs cannot be recommended. Prophylaxis with 1½ single strength trimethoprim-sulfamethoxazole or 100 mg trimethoprim nightly, every other night, or after intercourse effectively prevents recurrence of UTIs.