Primary prevention

The mainstay of UTI prevention is avoidance of known risk factors. Women who are prone to UTIs should avoid spermicidal products. Vaginal oestrogen therapy in post-menopausal women with symptomatic UTIs should be considered as a preventative measure.

Secondary prevention

Prevention of UTI includes reduction of modifiable risk factors, such as avoidance of spermicide products.

In patients with recurrent UTI, the risk of UTI can be reduced with low-dose antimicrobial prophylaxis, single-dose antimicrobial therapy before or after sexual intercourse, or self-initiated therapy. In post-menopausal women, the incidence of recurrence may be decreased with topical vaginal oestrogen cream.

There is little evidence to support hydration and urination soon after sexual intercourse for the prevention of UTIs.[22]

There has been conflicting evidence to support cranberry for the prevention of UTIs.[86][87][88]​ However, one Cochrane review updated in 2023 supports the use of cranberry products to reduce the risk of symptomatic, culture‐verified UTIs in women with recurrent UTIs.[89]

Another meta-analysis found that cranberry was associated with a protective effect.[90] The UK National Institute for Health and Care Excellence (NICE) found no evidence to support the use of cranberry products or urine alkalinising agents to treat lower UTI.[3]

One contributing factor to the controversial clinical results obtained with cranberry is the often lacking precise determination and authentication of the bioactive proanthocyanidin (PAC) of the A type content.[91] Cranberry supplements (containing 36 mg PAC per daily dose) prevented postoperative urinary tract infections in women undergoing benign gynaecological surgery involving urinary catheterisation.[92] Other studies have shown a reduction in UTI burden with daily cranberry juice intake in women with a recent history of UTI.[93] 

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