Recurrent UTIs

Indications for further UTI workup, from Campbell's

Workup and Diagnosis

Definitions

History

Exam

Adjuncts

Indications for cystoscopy and imaging

UTI management algorithm, from Campbell's

Management

Antibiotic therapy options

Vaginal estrogen

Non-abx proven therapies

Non-abx less proven therapies

Antibiotic options

Culture-proven UTI treatment TMP/SMX DS BID x3 days
Nitrofurantoin 100mg BID x5 days
Fosfomycin 3g single dose
Second line options: beta-lactams, fluoroquinolones
Daily prophylaxis TMP 100mg QD
TMP/SMX SS QD or SS 3x/week
Nitrofurantoin 50mg or 100mg QD
Cephalexin125mg or 250mg QD
Fosfomycin 3g q10d
Post-coital dose TMP/SMX SS or DS
Nitrofurantoin 50mg or 100mg
Cephalexin 250mg

References