Recurrent UTI in non-pregnant Women ≥ 3 UTIs/year
Antimicrobial prescribing: NHS Forth Valley
2 in 6 months or 3 or more per year
First line: advise simple measures including hydration; ibuprofen for symptom relief.
Cranberry products work for some women.
Second Line: Stand by or post-coital antibiotics.
Third line: antibiotic prophylaxis. (Risk of pulmonary fibrosis in patient taking long term nitrofurantoin). Consider methenamine (1g BD for 6 months and review) if no renal/hepatic impairment.
Drug details
Nitrofurantoin
50–100mg
Post coital stat (off-label)
Prophylaxis OD atnight review at 6 months
orTrimethoprim
100mg
Post coital stat (off-label)
Prophylaxis OD atnight review at 6 months