State-of-the-Art Review: Recurrent Uncomplicated Urinary Tract Infections in Women.
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2025-03
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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.
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Advani, Sonali D, Joshua T Thaden, Reinaldo Perez, Sabrina L Stair, Una J Lee and Nazema Y Siddiqui (2025). State-of-the-Art Review: Recurrent Uncomplicated Urinary Tract Infections in Women. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 80(3). pp. e31–e42. 10.1093/cid/ciae653 Retrieved from https://hdl.handle.net/10161/34618.
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Sonali Advani
Dr. Advani is an Adjunct Associate Professor of Medicine at Duke University School of Medicine. In July 2024, she joined GSK/ViiV Healthcare as a scientific leadership physician with cross functional experience across global medical affairs as well as Research & Development in HIV therapeutics and vaccines.
Prior to this, she served as a physician investigator in the Duke Center for Antimicrobial Stewardship and Infection Prevention, a Fellow in Implementation Science at HIGH IRI (HIV, Infectious Disease and Global Health Implementation Research) Institute at Washington University, St Louis and Associate Medical Director of Infection Prevention at Yale New Haven Hospital. Her research focused on improving the diagnosis of UTIs in older adults, implementation of diagnostic stewardship interventions, and de-prescribing antibiotics for asymptomatic bacteriuria. She was awarded the K12 Urologic Career Development Award, Pepper Center Career Development Award, and SHEA Research Scholar Award to continue her UTI related research. In addition, she was one of the key investigators for CDC Prevention Epicenter Program and CDC SHEPheRD Contract for the Use of Race, Ethnicity, and Social Determinants of Health Data in NHSN Measures to Promote Health Equity.
Joshua Thomas Thaden
Reinaldo Perez
Nazema Y. Siddiqui
Dr. Siddiqui is a clinician-scientist in the field of Urogynecology & Reconstructive Pelvic Surgery. She leads the Duke Urogenital Microbiome (Ur-BIOME) Research Program and has particular interest in how microbial factors influence recurrent UTIs and overactive bladder. She also serves as the Duke site PI for the Pelvic Floor Disorders Network, which is an NIH-sponsored group of investigators conducting clinical trials to improve the lives of women with pelvic floor issues.
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