Recurrent Cystitis in Women

Clinical Features And DiagnosisTop

Recurrent cystitis affects 10% to 20% of women without any risk factors for complicated urinary tract infection (UTI). Etiologic agents are the same as in uncomplicated sporadic cystitis. Reinfections are markedly more frequent than relapses. In some patients an evident relationship between sexual intercourses and subsequent episodes of UTI may be observed. When symptoms recur, obtain urine culture. Additional diagnostic tests (including imaging studies) are generally not recommended, unless risk factors for complicated UTI are suspected or rare uropathogens (eg, Proteus spp) are detected.

TreatmentTop

1. The same drugs may be used as in uncomplicated cystitis.

2. In some cases a recurrent UTI is actually a relapse. This occurs most frequently in patients in whom the previous episode of cystitis was accompanied by asymptomatic pyelonephritis that has not been successfully treated with a short course of antimicrobial therapy. In patients with a relapse of UTI, perform urine cultures and start empiric treatment with a different class of antibiotics until culture results are available.

PreventionTop

See Prevention (Urinary Tract Infections (UTIs)).