Urinary tract infections

Last updated: May 24, 2022

Summarytoggle arrow icon

Urinary tract infections (UTIs) are infections of the bladder, urethra, ureters, or kidneys that are most commonly caused by bacteria, especially E. coli. Infections of the bladder or urethra are called lower UTIs, whereas infections involving the kidneys or ureters are called upper UTIs. Because women have a shorter urethra and anal and genital regions that are closer in proximity, they are at higher risk of contracting UTIs than men. Other risk factors include sexual intercourse, indwelling urinary catheters, pregnancy, and abnormalities of the urinary tract. UTIs in otherwise healthy, nonpregnant, premenopausal women are considered uncomplicated. UTIs in men or individuals with other risk factors for treatment failure or serious outcomes, such as functional or anatomical abnormalities of the urinary tract, are considered complicated. Clinical findings depend on which part of the urinary tract is affected. Lower UTIs manifest with dysuria, suprapubic pain, urinary urgency, and increased urinary frequency, whereas upper UTIs additionally cause fever and flank pain. Diagnosis is usually clinical and can be supported with findings of pyuria and bacteriuria on urinalysis. A urine culture may be required for patients with a complicated lower UTI or equivocal urinalysis findings. Imaging is rarely required but may be indicated to rule out underlying factors (e.g., urinary tract obstruction, anatomical abnormalities). First-line empiric antibiotic therapy options for uncomplicated lower UTIs include oral nitrofurantoin, trimethoprim/sulfamethoxazole, or fosfomycin for up to 7 days. For complicated lower UTIs, broad-spectrum antibiotic therapy should be given for 7–14 days and treatable underlying factors should be addressed. Recurrent UTIs are common in women and antibiotic prophylaxis may be indicated. Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections; they are frequently caused by resistant bacteria and are treated with catheter removal or replacement in addition to antibiotic therapy. Pregnant women should be screened and treated both for UTIs and for asymptomatic bacteriuria. For the management of upper UTIs, see “Pyelonephritis.”

Pathogens

Bacteria

Viruses

Fungi [4]

Predisposing factors

Host-dependent factors

Other factors

SEEK PP = S - S. saprophyticus, E - E. coli, E - Enterococcus, K - Klebsiella, P - Proteus, P - Pseudomonas are the bacteria commonly associated with UTIs.

Urinary tract infections are classified and treated based on location, severity, source of infection, and frequency. The presence of symptoms distinguishes UTI from asymptomatic bacteriuria, which only requires treatment in a select subset of patients.

Classification of urinary tract infections [9]
Details
By clinical presentation [10] Asymptomatic bacteriuria (ASB)
Urinary tract infection (UTI)
By location [11] Lower UTI

Upper UTI

By severity [12][13][14] Uncomplicated UTI
  • Infection in nonpregnant, premenopausal women without further risk factors for infection, treatment failure, or serious outcomes [14]
Complicated UTI (cUTI)
Urosepsis
  • UTI associated with a dysregulated immune response that can potentially lead to life-threatening organ dysfunction (See also “Sepsis.”) [15]
By source of infection [16][17] Community-acquired UTI
  • UTI acquired outside of a healthcare setting and/or UTI that manifests within 48 hours of hospital admission
Healthcare-associated UTI
By frequency [10] Recurrent UTI
  • ≥ 3 episodes of symptomatic, culture-proven UTI in one year or ≥ 2 episodes in 6 months

In patients with fever and/or flank pain, which are usually absent in lower UTIs, consider a more serious infection (e.g., pyelonephritis).

Dysuria without urgency or frequency may suggest vaginitis or sexually transmitted urethritis rather than cystitis, especially if accompanied by abnormal vaginal or urethral discharge. [9]

In the following section, “UTI” refers to both upper and lower UTIs, while “lower UTI” typically refers to cystitis with or without urethritis (see “Classification” for details).

Approach [9][24]

Symptomatic, uncomplicated lower UTIs can be diagnosed clinically. In all other patients, urinalysis is the most important initial diagnostic test.

UTI is primarily a clinical diagnosis that is supported by typical findings on urinalysis. Urine culture is indicated in select cases to determine the causative pathogen and adapt antibiotic treatment.

Investigate isolated urethritis (i.e., without concomitant cystitis) for causes other than lower UTI (e.g., STI, reactive arthritis).

Laboratory studies [25]

Urinalysis [25][26]

Urine culture [9][14][25]

In patients with complicated or recurrent urinary tract infections, a urine culture should be obtained prior to initiating antibiotic treatment. False negative results are possible if a culture is obtained after the patient has received antibiotics.

In patients with lower abdominal pain and sterile pyuria, consider bladder or ureteral irritation from an intraabdominal or pelvic infection unrelated to the urinary tract (e.g., appendicitis, diverticulitis). [32][33]

Additional diagnostics [15][24][34]

Imaging [14][15][35]

Imaging is generally not indicated or helpful for the diagnosis of lower UTI, but it may be performed in select patients to rule out complicating factors (e.g., urinary tract obstruction) or if complicated pyelonephritis or urosepsis are suspected. For imaging indications and findings in upper UTI, see “Diagnostics” in “Pyelonephritis.”

Imaging is not routinely necessary for patients with uncomplicated lower UTI.

Interstitial cystitis (painful bladder syndrome) [36][37]

Asymptomatic bacteriuria (ASB) [27][43]

  • Description
    • Presence of ≥ 100,000 CFU/mL in at least two voided urine samples in patients with no symptoms of UTI (e.g., dysuria, frequency, urgency, suprapubic pain)
    • Bacteriuria typically resolves spontaneously in healthy, nonpregnant women without any side effects.
    • Women with asymptomatic bacteriuria may progress to symptomatic UTI in the future more often than women with no bacteriuria.
  • Epidemiology
  • Etiology: E. coli is the most common causative organism.
  • Risk factors
  • Diagnosis: urinalysis with microscopy
    • Mid-stream urine sample: bacterial growth ≥ 100,000 CFU/mL in two consecutive samples in women or in one sample in men
    • Catheterized urine sample: bacterial growth ≥ 100 CFU/mL in one sample in women or men
  • Management
    • Treatment is recommended in:
      • Individuals undergoing endourological procedures with possible mucosal trauma [44]
      • Pregnant women: See “Treatment of ASB and lower UTIs in pregnant women” below.
    • Treatment is not recommended in:

Other differential diagnoses

The differential diagnoses listed here are not exhaustive.

In the following section, “UTI” refers to both upper and lower UTIs, while “lower UTI” typically refers to cystitis with or without urethritis (see “Classification” for details).

General principles [9][14][24][46]

  • Antibiotic treatment is recommended for all patients with symptomatic UTI.
    • The optimal therapy depends on disease severity, local resistance patterns, and patient characteristics (e.g., allergies).
    • Initial treatment is with an empiric regimen, which is maintained for uncomplicated cystitis.
    • In unclear or complicated cases, the regimen may subsequently have to be adjusted based on urine culture data.
  • Consider the need for supportive treatment.
    • Phenazopyridine,; a urinary analgesic, can be used for symptomatic relief for a maximum of 2 days.
    • Oral analgesia, e.g., with NSAIDs, can provide additional relief.
  • For the treatment of upper UTI, see “Treatment of pyelonephritis.”

Consider empiric treatment of STIs in patients with isolated urethritis, prostatitis, or suspected pelvic inflammatory disease (see “Treatment of PID”).

Uncomplicated lower UTI [14][46][47]

  • Management can typically be done in the outpatient setting with oral therapy.
  • Treatment duration depends on the chosen antibiotic agent.
  • Symptom relief can be expected to occur after an average of 36 hours. [30]
  • Persistent symptoms despite antibiotic therapy suggest complicated UTI and/or indicate the need to change the empiric therapy.

Empiric antibiotic treatment of uncomplicated lower UTIs

Complicated lower UTI [9][14][48][49]

Antibiotic treatment of complicated lower UTIs [14][48]

Treatment regimens for UTI in men should include antibiotics that are able to penetrate prostate tissue (e.g., fluoroquinolones or TMP/SMX). Fosfomycin or nitrofurantoin are generally not adequate.

Management of complicating factors

  • Nephrolithiasis: In UTI with renal obstruction, urgent urology consultation is required for drainage. [52]
  • Indwelling medical devices (e.g., ureteral stents, percutaneous nephrostomy tubes) [53][54]
    • Management of infections may require exchange or removal of the device, especially when it is obstructed.
    • Urology should be consulted urgently for further management.
  • Other treatable factors should be addressed: e.g., optimal blood sugar control for diabetics.

Recurrent UTI [10][55]

Recurrent UTIs are common in women. Management involves the implementation of preventive measures and antibacterial prophylaxis in addition to the antibiotic treatment of acute episodes.

Acute management

Whenever possible, obtain a urine culture for every episode prior to initiating antibiotic therapy.

Antibiotic prophylaxis [10]

Nonantibiotic prophylaxis

  • There is insufficient high-quality data to support the use of cranberry products for preventing UTIs. [56][57]
  • Topical estrogen therapy should be considered in postmenopausal women.
  • Behavioral modifications (e.g., increased fluid intake, postcoital voiding) may be helpful.

Candiduria [58]

  • Candida isolated from the urine rarely indicates systemic infection, but it may be a marker for greater mortality in severely ill patients.
  • Predisposing factors should be treated in all cases of candiduria, e.g., by removing indwelling catheters whenever possible.
  • Indications for antifungal treatment include symptomatic cystitis or pyelonephritis, neutropenia, or a planned urologic procedure.
  • Commonly used antifungals include fluconazole and amphotericin B.
  • Consult the infectious disease service for assistance with appropriate antifungal treatment.

We list the most important complications. The selection is not exhaustive.

Overview [14][16]

Diagnostics

A urine culture, ideally obtained prior to antibiotic treatment, is always required to diagnose CAUTI.

  • Indications: features consistent with potential infection
  • Specimen collection: ideally from the sampling port of a newly inserted device using aseptic technique
  • Diagnostic criteria

To reduce false-positive results, avoid sampling urine for culture from previously inserted catheters or collection bags, as these sites are frequently colonized by bacteria within a few hours of catheter insertion. [62]

Treatment

UTI in older adults [63]

  • UTI is very common in advanced age, both in individuals who live in long-term care facilities and those who do not.
  • Symptoms of UTI are more commonly atypical (e.g., back pain, pelvic pain, constipation, urinary incontinence, and altered mental status).
  • Management principles are generally the same as outlined above.
  • Preventative strategies include increased fluid intake and increasing mobility (see also “Prevention” above).

UTI in pregnancy [64]

Pathophysiology

Asymptomatic bacteriuria in pregnancy [14][65]

Treatment of ASB and lower UTIs in pregnancy [14][66]

Although UTI in pregnancy is generally considered complicated, treatment regimens for ASB and lower UTI in pregnancy may include those typically used for uncomplicated UTI and should be adapted to the patient's individual risk and urine culture results. [14][65]

Asymptomatic bacteriuria in pregnancy is a risk factor for pyelonephritis and should be treated.

UTI in children and adolescents [67][68]

Epidemiology

  • UTIs are common in children.
  • Approx. 8% of girls and 2% of boys will have had a UTI by the age of 7 years.

Risk factors

Diagnosis

Treatment

  • Treatment principles in children are similar to those in adults.
  • Empiric therapy: Reasonable first-line options include : [67][69]
  • Antibiotics can be adjusted after culture and susceptibility results have been obtained.
  • When associated with structural abnormalities, additional management of the underlying condition may be required.

Oral and parenteral antibiotics are equally effective. Hospitalization should be considered in severely ill children and those unable to tolerate oral intake.

Interested in the newest medical research, distilled down to just one minute? Sign up for the One-Minute Telegram in “Tips and links” below.

  1. Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2). McGraw-Hill Education / Medical ; 2018
  2. Anger J, Lee U, Ackerman AL, et al. Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline. J Urol. 2019; 202 (2): p.282-289. doi: 10.1097/ju.0000000000000296 . | Open in Read by QxMD
  3. Katz MH, Doherty GM. Current Diagnosis and Treatment Surgery, 15th Edition. McGraw-Hill Education / Medical ; 2020
  4. Hooton TM. Uncomplicated Urinary Tract Infection. N Engl J Med. 2012; 366 (11): p.1028-1037. doi: 10.1056/nejmcp1104429 . | Open in Read by QxMD
  5. Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitis.. Am Fam Physician. 2011; 84 (7): p.771-6.
  6. 2021 EAU Guideline on Urological Infections. https://web.archive.org/web/20210611080346/https://uroweb.org/guideline/urological-infections/. Updated: March 1, 2021. Accessed: June 11, 2021.
  7. Walls R, Hockberger R, Gausche-Hill M. Rosen's Emergency Medicine. Elsevier Health Sciences ; 2018
  8. Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50 (5): p.625-663. doi: 10.1086/650482 . | Open in Read by QxMD
  9. Cardoso T, Almeida M, Friedman ND, et al. Classification of healthcare-associated infection: a systematic review 10 years after the first proposal. BMC Med. 2014; 12 (1). doi: 10.1186/1741-7015-12-40 . | Open in Read by QxMD
  10. Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014; 370 (13): p.1198-1208. doi: 10.1056/NEJMoa1306801 . | Open in Read by QxMD
  11. Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med. 2002; 113 (1): p.14-19. doi: 10.1016/s0002-9343(02)01055-0 . | Open in Read by QxMD
  12. Medical Student Curriculum: Pediatric Urinary Tract Infections. https://www.auanet.org/education/auauniversity/for-medical-students/medical-students-curriculum/medical-student-curriculum/pediatric-uti. Updated: July 1, 2016. Accessed: November 15, 2019.
  13. Paduch DA. Viral lower urinary tract infections.. Curr Urol Rep. 2007; 8 (4): p.324-35. doi: 10.1007/s11934-007-0080-y . | Open in Read by QxMD
  14. Kauffman CA. Diagnosis and Management of Fungal Urinary Tract Infection. Infect Dis Clin North Am. 2014; 28 (1): p.61-74. doi: 10.1016/j.idc.2013.09.004 . | Open in Read by QxMD
  15. Kauffman CA. Candiduria. Clin Infect Dis.. 2005; 41 (Supplement_6): p.S371-S376. doi: 10.1086/430918 . | Open in Read by QxMD
  16. Fischer C. Master the Boards USMLE Step 2 CK. Kaplan Publishing ; 2013
  17. Ahmad Nikibakhsh. Clinical Management of Complicated Urinary Tract Infection. InTech ; 2011
  18. Shapiro E. American academy of pediatrics policy statements on circumcision and urinary tract infection.. Rev Urol. 1999; 1 (3): p.154-6.
  19. Miller JM, Binnicker MJ, Campbell S, et al. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018; 67 (6): p.e1-e94. doi: 10.1093/cid/ciy381 . | Open in Read by QxMD
  20. Flores-Mireles et al. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology. 2015; 13 (5): p.269-284. doi: 10.1038/nrmicro3432 . | Open in Read by QxMD
  21. Hooton TM, Gupta K. Acute Uncomplicated Cystitis in Women. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/acute-uncomplicated-cystitis-in-women.Last updated: December 6, 2017. Accessed: April 4, 2018.
  22. Hooton TM, Gupta K. Acute Complicated Urinary Tract Infection (Including Pyelonephritis) in Adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/acute-complicated-urinary-tract-infection-including-pyelonephritis-in-adults.Last updated: March 16, 2018. Accessed: April 4, 2018.
  23. Korbel L, Howell M, Spencer JD. The clinical diagnosis and management of urinary tract infections in children and adolescents. Paediatrics and International Child Health. 2017; 37 (4): p.273-279. doi: 10.1080/20469047.2017.1382046 . | Open in Read by QxMD
  24. Kuswardhani RAT, Sugi YS. Factors Related to the Severity of Delirium in the Elderly Patients With Infection. Gerontology and Geriatric Medicine. 2017; 3 : p.233372141773918. doi: 10.1177/2333721417739188 . | Open in Read by QxMD
  25. Gupta K. Urinary Tract Infection. Ann Intern Med. 2012; 156 (5): p.ITC3. doi: 10.7326/0003-4819-156-5-201203060-01003 . | Open in Read by QxMD
  26. Wilson ML, Gaido L. Laboratory Diagnosis of Urinary Tract Infections in Adult Patients. Clin Infect Dis. 2004; 38 (8): p.1150-1158. doi: 10.1086/383029 . | Open in Read by QxMD
  27. Simerville JA, Maxted WC, Pahira JJ. Urinalysis: a comprehensive review.. Am Fam Physician. 2005; 71 (6): p.1153-62.
  28. Colgan R, Nicolle LE, McGlone A, Hooton TM. Asymptomatic bacteriuria in adults.. Am Fam Physician. 2006; 74 (6): p.985-90.
  29. Brown PD. Management of Urinary Tract Infections Associated with Nephrolithiasis. Curr Infect Dis Rep. 2010; 12 (6): p.450-454. doi: 10.1007/s11908-010-0141-0 . | Open in Read by QxMD
  30. Mody L, Juthani-Mehta M. Urinary Tract Infections in Older Women. JAMA. 2014; 311 (8): p.844. doi: 10.1001/jama.2014.303 . | Open in Read by QxMD
  31. Colgan, Williams. Diagnosis and Treatment of Acute Uncomplicated Cystitis. American Family Physician. 2011 .
  32. Doern CD, Richardson SE. Diagnosis of Urinary Tract Infections in Children. J Clin Microbiol. 2016; 54 (9): p.2233-2242. doi: 10.1128/jcm.00189-16 . | Open in Read by QxMD
  33. Hooker JB, Mold JW, Kumar S. Sterile Pyuria in Patients Admitted to the Hospital With Infections Outside of the Urinary Tract. J Am Board Fam Med .. 2014; 27 (1): p.97-103. doi: 10.3122/jabfm.2014.01.130084 . | Open in Read by QxMD
  34. Goonewardene S, Persad R. Sterile pyuria: a forgotten entity. Ther Adv Urol.. 2015; 7 (5): p.295-298. doi: 10.1177/1756287215592570 . | Open in Read by QxMD
  35. Beth N. Peshkin, MS, CGC,Michelle L. Alabek, MS, and Claudine Isaacs, MD. BRCA1/2 mutations and triple negative breast cancers.. Breast Disease. 2010 .
  36. Venkatesan AM, Oto A, Allen BC, et al. ACR Appropriateness Criteria® Recurrent Lower Urinary Tract Infections in Females. J Am Coll Radiol. 2020; 17 (11): p.S487-S496. doi: 10.1016/j.jacr.2020.09.003 . | Open in Read by QxMD
  37. Hanno PM, Erickson D, Moldwin R, et al. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment. J Urol. 2015; 193 (5): p.1545-1553. doi: 10.1016/j.juro.2015.01.086 . | Open in Read by QxMD
  38. American Urological Association: Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome Guideline. https://www.auanet.org/guidelines/interstitial-cystitis-(ic/bps)-guideline. Updated: January 1, 2014. Accessed: July 31, 2020.
  39. McKernan LC, Walsh CG, Reynolds WS, Crofford LJ, Dmochowski RR, Williams DA. Psychosocial co-morbidities in Interstitial Cystitis/Bladder Pain syndrome (IC/BPS): A systematic review. Neurourol Urodyn. 2017; 37 (3): p.926-941. doi: 10.1002/nau.23421 . | Open in Read by QxMD
  40. Clauw DJ, Schmidt M, Radulovic D, Singer A, Katz P, Bresette J. The relationship between fibromyalgia and interstitial cystitis.. J Psychiatr Res. 1997; 31 (1): p.125-31. doi: 10.1016/s0022-3956(96)00051-9 . | Open in Read by QxMD
  41. Watkins KE, Eberhart N, Hilton L, et al. Depressive disorders and panic attacks in women with bladder pain syndrome/interstitial cystitis: a population-based sample. Gen Hosp Psychiatry. 2011; 33 (2): p.143-149. doi: 10.1016/j.genhosppsych.2011.01.004 . | Open in Read by QxMD
  42. Kuo Y-C, Kuo H-C. O’Leary-Sant Symptom Index Predicts the Treatment Outcome for OnabotulinumtoxinA Injections for Refractory Interstitial Cystitis/Bladder Pain Syndrome. Toxins. 2015; 7 (8): p.2860-2871. doi: 10.3390/toxins7082860 . | Open in Read by QxMD
  43. Bosch PC. Examination of the Significant Placebo Effect in the Treatment of Interstitial Cystitis/Bladder Pain Syndrome. Urology. 2014; 84 (2): p.321-326. doi: 10.1016/j.urology.2014.04.011 . | Open in Read by QxMD
  44. Guidelines on Urological infections 2019. https://uroweb.org/wp-content/uploads/EAU-Guidelines-on-Urological-infections-2019.pdf. Updated: March 1, 2019. Accessed: August 12, 2020.
  45. Asymptomatic Bactetiuria. https://www.aafp.org/afp/2020/0715/p99.html. Updated: July 15, 2020. Accessed: August 18, 2020.
  46. Le T, Bhushan V, Chen V, King M. First Aid for the USMLE Step 2 CK. McGraw-Hill Education ; 2015
  47. Gupta K, Hooton TM, Naber KG, et al. International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011; 52 (5): p.e103-e120. doi: 10.1093/cid/ciq257 . | Open in Read by QxMD
  48. Lee RA, Centor RM, Humphrey LL, Jokela JA, Andrews R, Qaseem A. Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians. Ann Intern Med. 2021 . doi: 10.7326/m20-7355 . | Open in Read by QxMD
  49. Murphy JE, Lee MW-L. PSAP 2018 Book 1: Infectious Diseases. American College of Clinical Pharmacy ; 2018
  50. Levison ME, Kaye D. Treatment of Complicated Urinary Tract Infections With an Emphasis on Drug-Resistant Gram-Negative Uropathogens. Curr Infect Dis Rep. 2013; 15 (2): p.109-115. doi: 10.1007/s11908-013-0315-7 . | Open in Read by QxMD
  51. Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Elsevier ; 2019
  52. Derington CG, Benavides N, Delate T, Fish DN. Multiple-Dose Oral Fosfomycin for Treatment of Complicated Urinary Tract Infections in the Outpatient Setting. Open Forum Infect Dis. 2020; 7 (2). doi: 10.1093/ofid/ofaa034 . | Open in Read by QxMD
  53. Assimos D, Krambeck A, Miller NL et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol. 2016; 196 (4): p.1161-1169. doi: 10.1016/j.juro.2016.05.091 . | Open in Read by QxMD
  54. Dyer RB, Chen MY, Zagoria RJ, Regan JD, Hood CG, Kavanagh PV. Complications of Ureteral Stent Placement. RadioGraphics. 2002; 22 (5): p.1005-1022. doi: 10.1148/radiographics.22.5.g02se081005 . | Open in Read by QxMD
  55. Huang S, Philip A, Richter M, Gupta S, Lessne M, Kim C. Prevention and Management of Infectious Complications of Percutaneous Interventions. Semin Intervent Radiol. 2015; 32 (02): p.078-088. doi: 10.1055/s-0035-1549372 . | Open in Read by QxMD
  56. Kodner CM, Thomas Gupton EK. Recurrent urinary tract infections in women: diagnosis and management.. Am Fam Physician. 2010; 82 (6): p.638-43.
  57. Ruth G Jepson, Gabrielle Williams, Jonathan C Craig. Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews. 2012 . doi: 10.1002/14651858.cd001321.pub5 . | Open in Read by QxMD
  58. Luís Â, Domingues F, Pereira L. Can Cranberries Contribute to Reduce the Incidence of Urinary Tract Infections? A Systematic Review with Meta-Analysis and Trial Sequential Analysis of Clinical Trials. J Urol. 2017; 198 (3): p.614-621. doi: 10.1016/j.juro.2017.03.078 . | Open in Read by QxMD
  59. Pappas PG, Kauffman CA, Andes DR et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2015; 62 (4): p.e1-e50. doi: 10.1093/cid/civ933 . | Open in Read by QxMD
  60. Loh K, Sivalingam N. Urinary tract infections in pregnancy.. Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia. 2007; 2 (2): p.54-7.
  61. Verma I, Avasthi K, Berry V. Urogenital infections as a risk factor for preterm labor: a hospital-based case-control study.. J Obstet Gynaecol India. 2014; 64 (4): p.274-8. doi: 10.1007/s13224-014-0523-6 . | Open in Read by QxMD
  62. Ghouri F, Hollywood A, Ryan K. A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy.. BMC Pregnancy Childbirth. 2018; 18 (1): p.99. doi: 10.1186/s12884-018-1732-2 . | Open in Read by QxMD
  63. Rowe TA, Juthani-Mehta M. Diagnosis and Management of Urinary Tract Infection in Older Adults. Infect Dis Clin North Am. 2014; 28 (1): p.75-89. doi: 10.1016/j.idc.2013.10.004 . | Open in Read by QxMD
  64. Schnarr J, Smaill F. Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy. Eur J Clin Invest. 2008; 38 : p.50-57. doi: 10.1111/j.1365-2362.2008.02009.x . | Open in Read by QxMD
  65. Nicolle LE, Gupta K, Bradley SF, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2019 . doi: 10.1093/cid/ciy1121 . | Open in Read by QxMD
  66. Bookstaver PB, Bland CM, Griffin B, Stover KR, Eiland LS, McLaughlin M. A Review of Antibiotic Use in Pregnancy. Pharmacotherapy. 2015; 35 (11): p.1052-1062. doi: 10.1002/phar.1649 . | Open in Read by QxMD
  67. Diagnosis and Treatment of Urinary Tract Infections in Children. https://www.aafp.org/afp/2011/0215/p409.html. Updated: February 15, 2011. Accessed: August 5, 2020.
  68. Kaufman J, Temple-Smith M, Sanci L. Urinary tract infections in children: an overview of diagnosis and management. BMJ Paediatrics Open. 2019; 3 (1): p.e000487. doi: 10.1136/bmjpo-2019-000487 . | Open in Read by QxMD
  69. Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months. Pediatrics. 2011; 128 (3): p.595-610. doi: 10.1542/peds.2011-1330 . | Open in Read by QxMD

3 free articles remaining

You have 3 free member-only articles left this month. Sign up and get unlimited access.
 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer