Recurrent UTI
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
N10.0/N30.9/N39.0
DESCRIPTION
Recurrences of uncomplicated and/or complicated UTIs, with a frequency of at least three UTIs/year or two UTIs in the last six months. Send urine for microscopy, culture and sensitivity as treatment is determined by the results.
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GENERAL MEASURES
Women should void soon after intercourse.
Identify and treat hormone-deficient atrophic vulvo-vaginitis in the elderly.
MEDICINE TREATMENT
Prophylaxis Z29.9
To reduce risk of recurrence in patients with >3 infections/year requires continuous prophylaxis for 6 months:
- Cotrimoxazole 80/400 mg, oral, 1 tablet at night.
Treatment
Treat according to microscopy, culture and sensitivity.
REFERRAL/CONSULTATION
- Failure to respond to prophylactic treatment.
- Uncertain diagnosis.
- Recurrent infections where no facilities exist for adequate culture of urine.
- All complicated recurrent UTIs.
- STI pathogens.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_17 October 2024
Chapter 7 Nephrology/Urological Disorders_7.3 Urological Disorders_7.3.3 Recurrent UTI