RECURRENT URINARY TRACT INFECTIONS: CHALLENGES IN MANAGEMENT AND STRATEGIES FOR RECURRENCE PREVENTION - A REVIEW ARTICLE

Urinary tract infection (UTI) is one of the most common infectious diseases among adults and is caused by the presence of microorganisms in the urinary tract. Bacteria from the group of uropathogenic Escherichia coli strains, known as UPEC, play a central role in the etiology of these infections. Epidemiological data indicate that nearly half of all women worldwide will experience at least one UTI in their lifetime, and a significant proportion will struggle with recurrent infections. This problem is particularly prevalent among young, sexually active women, as well as those of menopausal age, which may be partially explained by age-related impairments in immune function. Currently, one of the major challenges in contemporary clinical practice is the increasing antibiotic resistance among UTI-causing bacteria. Specialists emphasize that targeted therapy, along with non-antibiotic or alternative methods, is essential in addressing this problem and preventing recurrent UTIs. The following overview assesses the effectiveness of the most common methods of preventing recurrent urinary tract infections, based on recent publications. These approaches include both non-pharmacological methods such as adequate hydration, proper hygiene, and appropriate contraception, as well as pharmacological methods including antibiotic therapy, D-mannose supplementation, and vaginal estrogen therapy. Each method is based on a different mechanism of action, from mechanical removal of bacteria and competitive inhibition of bacterial adhesion to stimulation of immune defenses. Despite differing pathways, all these mechanisms share a single overarching goal: to prevent urinary tract infection.