Prevention and treatment of recurrent urinary tract infections in women

       Urinary tract infections are common in women, and about 10% to 20% of women have had at least one or more urinary tract infections. Among them, many susceptible, sexually active and pre- and post-menopausal women are especially prone to recurrence of urinary tract infections, as few as 1-2 times/year or as many as 1-2 times a month. Most patients have symptoms of frequent, urgent and painful urination; a few may have symptoms of fever and back pain. For this group of patients, the aim of treatment is not only to improve symptoms, but also to prevent further infection and reduce recurrence. After a woman has had 1 or 2 urinary tract infections, she will be personally aware of the disease and will be able to make a self-diagnosis and manage it.  The following treatment principles should be followed when receiving treatment: 1. Application of antimicrobial therapy must be carried out under the guidance of a specialist.  2. Antimicrobial therapy should not be stopped immediately after it is effective, but should be continued for 3 to 7 days. In the case of acute pyelonephritis, it should be taken continuously for 4-6 weeks, and it is best to change an effective antimicrobial agent every week.  Recurrent urinary tract infections should not be treated repeatedly with the same type of antimicrobial agent, otherwise the body is susceptible to drug resistance and affect the efficacy.  4, for the initial treatment effect is not good, should find the cause as soon as possible, for the middle urine culture and bacterial sensitivity test.  The most effective program to prevent recurrent urinary tract infections is the prophylactic treatment with small doses of antimicrobials. The prerequisite for this regimen is that the urinary tract infection has been controlled by conventional therapy. Any first-line drug given at night at 1/4 to 1/6 of its regular daily dose for 6 to 12 weeks can significantly reduce the recurrence rate of urinary tract infections and can alter the cycle of recurrent infections.  Commonly used prophylactic medications include: furantoin, vincristine IV, and cotrimoxazole. If the infection recurs even after the patient stops this low-dose prophylaxis regimen, consider extending the duration of prophylactic antimicrobial use for up to 2 years. Alternatively, drug administration may be changed to every other day. For young women who are sexually active, a single post-coital dose of an antimicrobial can significantly reduce the recurrence of urinary tract infections.