BMJ  2006;332:94-97 (14 January), doi:10.1136/bmj.332.7533.94

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Urinary tract infections in women: diagnosis and management in primary care

Josip Car, clinical research fellow1

1 Department of Primary Care and Social Medicine, Imperial College, London W6 8RP josip.car@imperial.ac.uk

Urinary tract infections are the second most common infections, causing considerable anxiety and morbidity in women. Care is not always optimal—prophylaxis is rarely considered and unnecessary investigations are requested. This evidence based approach to management of urinary tract infections in women highlights that some common recommendations, such as postcoital voiding, have no evidence base

The first 150 words of the full text of this article appear below.

Cystitis is an infection of the lower urinary tract which causes pain when passing urine and causes frequency, urgency, haematuria, or suprapubic pain not associated with passing urine.1

Upper urinary tract infection (pyelonephritis) is suggested by the presence of fever, flank pain, nausea, or vomiting. White blood cells are usually present in the urine, and occasionally white blood cell casts are also seen on urine microscopy.w1

Who gets them?

Urinary tract infections affect up to 15% of women each year.2 3 More than 25% of women who have had an infection will experience a recurrence.w2

The most important risk factors for acute cystitis in young women are a history of previous episodes of cystitis and frequent or recent sexual activity.w3 w4 The relative odds of acute cystitis increase by a factor of 60 during the 48 hours after sexual intercourse.w4 The use of spermicidal agents increases the odds of infection by Escherichia coli or by . . . [Full text of this article]

How do I diagnose them?


History
Examination
Investigation

What else could these symptoms indicate?


How should I treat urinary tract infections?


Non-drug measures
Drug measures

Prevention


Follow-up



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  • O'Brien, K., Hillier, S., Simpson, S., Hood, K., Butler, C. (2007). An observational study of empirical antibiotics for adult women with uncomplicated UTI in general practice. J Antimicrob Chemother 59: 1200-1203 [Abstract] [Full text]  
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