Recurrent UTI in Female

Vu Le ChuyenVietnam Speaker Recurrent UTI in FemaleBackground: Recurrent urinary tract infections (rUTIs) in women present a significant clinical burden due to their high prevalence, impact on quality of life, and growing antibiotic resistance. Despite decades of research, prevention and long-term management remain challenging, requiring a multifaceted approach. Objectives: This presentation aims to provide an evidence-based update on the definition, epidemiology, risk factors, antimicrobial resistance, and prevention strategies for rUTIs in women, with special consideration of individual patient factors and emerging alternatives to antibiotic therapy. Methods and Evidence Review: Current literature and international guidelines were reviewed, including randomized controlled trials, meta-analyses, and consensus statements. Key studies addressed behavioral modifications, increased fluid intake, use of cranberry products, methenamine hippurate, D-mannose, vaginal estrogen therapy, and prophylactic antibiotics. Comparative effectiveness data between non-antibiotic strategies and vaccination were also examined. Results: Multiple non-antibiotic preventive strategies demonstrated clinically meaningful reductions in rUTI recurrence. For instance, vaginal estrogen showed a significant reduction in postmenopausal women (50% vs. 94% recurrence; p = 0.041). Methenamine and D-mannose also presented promising outcomes with fewer side effects than continuous antibiotics. Barriers to adherence and challenges in special populations (e.g., older adults) were identified as persistent obstacles to optimal management. Conclusion: Effective rUTI management in women requires individualized strategies that incorporate patient risk factors, antimicrobial stewardship, and evidence-based non-antibiotic therapies. Future directions include improved vaccine development and microbiome-based interventions. Enhancing patient adherence and addressing knowledge gaps will be key to reducing recurrence and improving outcomes