MBBS, FRACS (Urol), Urological Surgeon, Australian Urology Associates, Vic; Cabrini Health, Vic; The Alfred Hospital, Vic.
MBBS (Hons), FRACS (Urol), Urological Surgeon, Australian Urology Associates, Vic; Cabrini Health, Vic; The Alfred Hospital, Vic.
Aust J Gen Pract. 2021 Apr;50(4):199-205. doi: 10.31128/AJGP-11-20-5728.
Recurrent urinary tract infections (rUTIs) and recurrent cystitis symptoms without infection occur commonly in women and present frequently in general practice.
The aim of this article is to provide a management approach to the assessment and treatment of recurrent cystitis symptoms in women with rUTIs as well as women who have negative urine cultures.
Five common clinical scenarios are discussed with different approaches to treatment: true rUTIs with positive urine cultures, women with variable urine cultures (some positive and some negative), women with negative urine cultures who have pyuria +/- haematuria, women with completely normal urine cultures and women with ongoing symptoms after a definite UTI. Red flags signalling the need for early referral to a urologist for further assessment are discussed. Both non-antibiotic and antibiotic-related strategies to treat women with rUTIs are available.
复发性尿路感染（rUTIs）和无感染的复发性膀胱炎症状在女性中很常见，并且在普通诊所中经常出现。
本文旨在为 rUTIs 女性以及尿液培养阴性的女性的复发性膀胱炎症状的评估和治疗提供一种管理方法。
讨论了五种常见的临床情况，并讨论了不同的治疗方法：尿液培养阳性的真性 rUTIs、尿液培养结果多变（部分阳性，部分阴性）的女性、尿液培养阴性但有脓尿 +/- 血尿的女性、尿液培养完全正常的女性以及在明确尿路感染后仍有持续症状的女性。讨论了需要及早转介泌尿科医生进一步评估的警示信号。针对 rUTIs 女性，既有非抗生素相关的治疗策略，也有抗生素相关的治疗策略。
