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Management of females with urinary tract infections (UTI)
Pre-menopausal women with single relapsing or recurrent UTI's can be managed in the community. Referral should only be considered if antibiotic prophylaxis has failed
Post-menopausal women should be referred if red flags are suspected or indications below. If no evidence of red flags patient should be given an adequate trial of antibiotic prophylaxis as per Formulary guidance before referral.
Formulary chapter 5 - Infections/urinary-tract-infections
Formulary chapter 5 - Infections/urinary-tract-infections
Typical features include:
Consider vaginal examination, looking for example for atrophic vaginitis and prolapse
Suspected urological cancer see 2ww guideline
DO NOT perform dipsticks in women over 65 years of age as bacteriuria is common in this age group so does not indicate infection.
General measures and advice:
Pre-menopausal women with single relapsing or recurrent UTI's should be managed in the community. Referral should only be considered if antibiotic prophylaxis has failed or investigations show abnormalities or risk factors present see below
Post-menopausal women should be referred if red flags are suspected or risk factors present. If no evidence of red flags patient should be given an adequate trial treatment (see above) before referral
Arrange urgent 2-week wait referral if a urological cancer is suspected.
Consider routine referral for women with recurrent UTIs and with any of the following risk factors:
e-Referral Service Selection
Northern Devon Healthcare Trust open appointment pathway
We have learnt from experience that not all patients who are seen in the complex UTI clinic need a routine follow-up appointment after consultation. After an initial consultation the clinician may place patients on an open appointment pathway, which means that if patients have any concerns within six months of their consultation, they can easily get in touch with us. If a patient develops a problem after this six-month period, they will need to contact their GP and ask for a re-referral
https://cks.nice.org.uk/urinary-tract-infection-lower-women
This guideline has been signed off by NHS Devon.
Publication date: February 2019