AUA Releases Joint Clinical Guideline for Recurrent Urinary Tract Infections in Women with CUA and SUFU

San Francisco, CA ( -- The American Urological Association (AUA), a leading global urology association, released a new joint clinical guideline with the Canadian Urological Association (CAU) and Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU), on the diagnosis and treatment of recurrent urinary tract infections (UTIs) in women.

UTIs are the most common bacterial infection in women, with approximately 50-60 percent of women experiencing at least one at some point in their lives. UTIs are considered recurrent if they occur two or more times in a six-month period, or three or more times in a year. Most UTIs go away with a short course of antibiotics; however, women with recurrent UTIs often require an approach to prevent a recurrence, depending on the frequency or cause of the infections.
“Recurrent UTI is a highly prevalent, costly and burdensome condition affecting women of all ages, races and ethnicities,” said Jennifer Anger, MD, MPH chair of the guideline development panel and urologist at Cedars-Sinai in Los Angeles, California. “With more cases reported each year, it is our hope this guideline provides physicians with a roadmap to reduce the number of UTIs in women, enhance patient health outcomes while also actively practicing antibiotic stewardship.”

The joint clinical guideline for the evaluation and treatment of women with recurrent UTIs makes 16 recommendations, including:

  • Clinicians should obtain a urinalysis and urine culture with each symptomatic acute cystitis (bladder infection) episode prior to initiating treatment.
  • Asymptomatic bacteriuria should not be treated (a condition in which bacteria are present in the urine, but there are no symptoms).
  • Based on the local antibiogram, clinicians should use first-line therapy (i.e., nitrofurantoin, TMPSMX, fosfomycin) for the treatment of symptomatic UTIs in women.
  • Clinicians should repeat urine culture to guide further management when UTI symptoms persist following antimicrobial therapy.
  • In peri- and post-menopausal women with recurrent UTIs, clinicians should recommend vaginal estrogen therapy to reduce the risk of future UTIs
The guideline was developed by a panel with specific expertise in the guideline subject. It was then distributed to peer reviewers of varying backgrounds as part of the AUA’s extensive peer review process before being finally approved by the AUA Board of Directors. Read the full guideline.