SOGC CLINICAL PRACTICE GUIDELINE
SOGC MEDICAL PRACTICE GUIDELINE
No . two hundred fifity, November 2010
Recurrent Urinary Tract Infection
This kind of Clinical Practice Guideline continues to be prepared by the Urogynaecology Committee, reviewed by the Family Medical professionals Advisory Panel, and given the green light by the Executive and Authorities of the Culture of Obstetricians and Gynaecologists of Canada. PRINCIPAL EXPERTS Annette Epp, MD, Saskatoon realtor SK Annick Larochelle, MD, St . Lambert QC UROGYNAECOLOGY COMMITTEE Danny Lovatsis, MD (Chair), Toronto ON Jens-Erik Walter, MARYLAND (Co-Chair), Westmount QC Bill Easton, MD, Scarborough ABOUT Annette Epp, MD, Saskatoon realtor SK Jeff A. Farrell, MD, Halifax NS Lise Girouard, RN, Winnipeg MB Chander Gupta, MD, Winnipeg MB Marie-AndrГ©e Harvey, MARYLAND, Kingston IN Annick Larochelle, MD, St Lambert QC Magali Robert, MD, Calgary AB File suit Ross, PhD, Calgary STOMACH Joyce Schachter, MD, Ottawa ON Jane A. Schulz, MD, Edmonton AB David Wilkie, MD, Vancouver BC FAMILY MEDICAL PROFESSIONALS ADVISORY PANEL William Ehman, MD (Chair), Naniamo BC Sharon Domb, MD, Barcelone ON AndrГ©e Gagnon, MD, Blainville QC Owen Barnes, MD, Ottawa ON Jill Konkin, MD, Edmonton STOMACH Joanna Lynch, MD, Winnipeg MB Cindy Marshall, MARYLAND, Lower Sackville NS Disclosure statements have been completely received coming from all users of the committees. The literary works searches and bibliographic support for this standard were taken on by Becky Skidmore, Medical Research Expert, Society of Obstetricians and Gynaecologists of Canada. Target: To provide an update of the classification, epidemiology, medical presentation, investigation, treatment, and prevention of recurrent urinary tract attacks in ladies. Options: Ongoing antibiotic prophylaxis, post-coital antibiotic prophylaxis, and acute self-treatment are all effective alternatives in order to avoid recurrent urinary tract contamination. Vaginal estrogen and cranberry juice may also be effective prophylaxis alternatives. Evidence: A search of PubMed as well as the Cochrane Selection for content published in English discovered the most relevant literature. Results were restricted to methodical reviews, randomized control trials/controlled clinical trials, and observational studies. There were zero date restrictions. Values: This kind of update may be the consensus of the Sub-Committee upon Urogynaecology in the Society of Obstetricians and Gynaecologists of Canada. Advice were made in line with the guidelines produced by the Canadian Task Force on Precautionary Health Care (Table 1). Choices: Recurrent urinary tract infections need cautious investigation and can be efficiently treated and averted. Different prophylaxis options could be selected relating to each person's characteristics. Advice 1 . Urinalysis and before your done urine lifestyle and tenderness should be performed with the first presentation of symptoms to be able to establish a accurate diagnosis of persistent urinary system infection. (III-L) 2 . People with persistent hematuria or persistent growth of bacteria besides Escherichia coli should undergo cystoscopy and imaging from the upper urinary tract. (III-L) 3. Sexually active women suffering from repeated urinary tract infections and using spermicide should be encouraged to consider an alternative sort of contraception. (II-2B) 4. Prophylaxis for recurrent urinary system infection ought not to be undertaken until a negative culture 1 to 2 weeks after treatment has proved eradication in the urinary tract infection. (III-L) 5. Constant daily antibiotic prophylaxis using cotrimoxazole, nitrofurantoin, cephalexin, trimethoprim, trimethoprimsulfamethoxazole, or possibly a quinolone throughout a 6- to 12-month period should be agreed to women with Ві a couple of urinary system infections in 6 months or Ві three or more urinary system infections in 12 months. (I-A) 6. Females with repeated urinary system infection linked to sexual intercourse needs to be offered post-coital prophylaxis rather than continuous remedy in order to minimize cost and side effects. (I-A)
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SOGC CLINICAL PRACTICE GUIDELINE
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