Urinary tract infection (UTI) is the most common bacterial infection encountered in the ambulatory setting in the US. By the age of 32 years, half of all women have reported at least one UTI. Young healthy women have a 25% chance of recurrence within six months.
Risk factors for uncomplicated UTI include sexual intercourse, new sex partner (within past year), use of spermicides, previous UTI and history of urinary tract infections in a first degree relative (mother, sister, daughter). There is no association with precoital or postcoital voiding patterns, daily beverage consumption, frequency of urination, delayed voiding habits, wiping patterns, tampon use, douching, use of hot tubs, type of underwear, or body mass index.
Urinary tract infections rarely progress to pyelonephritis (kidney infection). However, UTI is associated with considerable discomfort and antimicrobial drugs are prescribed to rapidly resolve the symptoms. Short courses of antibiotics are recommended as first-line treatment. The physician will choose a medication n the basis of the patient’s allergy and compliance history, local practice patterns, the prevalence of resistance in the local community, availability, cost, and patient and physician threshold for failure (choosing the wrong medication).
The key to management of UTI is to improve the quality of life while minimizing antimicrobial exposure.
The New England Journal of Medicine has an excellent review of uncomplicated UTI.