Uncomplicated Urinary Tract Infection in Adults Including Uncomplicated Pyelonephritis

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Acute uncomplicated urinary tract infection and acute pyelonephritis are very common infections affecting many women throughout their lives. The determinants of infection have been well described and current strategies to prevent recurrent infections are highly effective. While antimicrobial management is straightforward for most episodes, the evolution of antimicrobial susceptibility of E. coli in community-acquired infection requires continuing re-evaluation of appropriate empiric therapy.

Section snippets

Epidemiology

As many as 10% of women experience at least one episode of acute uncomplicated urinary infection in a year, and 60% have at least one episode during their lifetime [10]. The peak incidence of infection occurs in young, sexually active, women aged 18 to 24 years [1]. Recurrent episodes are experienced by as many as 5% of women at some time during their life [11]. In a primary care setting, 44% of women presenting with an infection experienced a second infection within 1 year [12]; 21% of college

Acute nonobstructive pyelonephritis

Acute nonobstructive pyelonephritis occurs in the same women who experience acute uncomplicated cystitis, but is less common. The relative frequency of pyelonephritis to cystitis for women with recurrent acute uncomplicated urinary infection was 18 to 1 [67] in a Seattle urinary infection referral cohort, and 29 to 1 in a Finland primary care cohort [12]. The genetic and behavioral risk factors associated with pyelonephritis are similar to those for acute, uncomplicated infection [68]. For

Summary

Acute uncomplicated urinary tract infection and acute pyelonephritis are common infections that occur in a substantial number of otherwise healthy women. The treatment of individual episodes is generally straightforward, with the more difficult management problem being the effective treatment and prevention of recurrent infection. There is substantial knowledge describing precipitating factors for infection, particularly the pivotal role of sexual intercourse. However, further investigation to

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