Management of urinary tract infections in the era of increasing antimicrobial resistance

Med Clin North Am. 2013 Jul;97(4):737-57, xii. doi: 10.1016/j.mcna.2013.03.006. Epub 2013 Apr 29.


Antimicrobial resistance of urinary pathogens is increasing. Most urinary tract infections (UTIs) should still be treated empirically. However, patients with recurrence or other risk factors for resistance may benefit from urine culture. Patients with recurrent UTI often resort to antibiotic prevention, a risky proposition in terms of resistance. Non-antimicrobial preventative methods should be considered first. If preventative antibiotics must be used, postcoital patient-initiated protocols are effective and reduce overall antibiotic exposure compared with continuous prophylaxis. Consider referring patients for urologic evaluation when at risk for complicated UTIs or when recurrence continues despite conservative interventions.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Drug Resistance, Bacterial*
  • Humans
  • Inappropriate Prescribing / prevention & control
  • Life Style
  • Risk Factors
  • Secondary Prevention / methods
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / prevention & control


  • Anti-Bacterial Agents