Clinical diagnosis of urinary tract infections is based on the presence of urinary symptoms such as itching during urination, increased urination frequency, pain during micturition and even haematuria. Urine studies through urine culture allows identifying the microorganism that causes it and determining effective antibiotics for its management.
Treatment of urinary tract infections is based on the use of antibiotics when there are compatible symptoms. In addition, measures aimed at modifying possible risk factors such as adequate bladder voiding and preventing infections associated with sexual relations should be considered.
The choice of antibiotic treatment for urinary tract infections requires taking into account existing resistance to ensure the effectiveness of the treatment. Short-term treatments are usually recommended. Although urinary tract infections usually occur in isolation, in many cases women experience recurrent urinary tract infections, i.e. when there are more than two urinary tract infections in six months or three in a year’s time, requiring confirmation with a positive urine culture. Although there are usually no causes that trigger recurrent urinary tract infections, anatomical or functional abnormalities of the urinary tract should be ruled out.
Treatment of urinary tract infections includes antibiotic therapy during the episodes of urinary infection along with precautionary measures to decrease recurrence. Precautionary measures include behavioural aspects such as acting on risk factors, avoid urine retention and postcoital micturition. Other measures on which studies have been published assessing their efficacy include topical hormone replacement therapy in postmenopausal women, immunoactive prophylaxis, use of probiotics, cranberry derivatives, D-mannose and intravesical instillations. Although antimicrobial agents have been widely used preventively, precautions should be taken as they can modify saprophytic flora and associate resistance.
Currently, it is recommended to minimise the use of antibiotics and, therefore, treatments based on the regeneration of the bladder antibacterial mucosal barrier and optimising immunity against microorganisms causing urinary tract infections should be considered.