New Trends in Medical Therapy of Resistant Urinary Tract Infections

This review examines emerging strategies for managing urinary tract infections (UTIs), with a focus on reducing antibiotic use and improving outcomes in the face of rising incidence, recurrence, and antimicrobial resistance. Key developments in diagnostics and treatment are assessed to clarify their role in current UTI care. Seventy-nine studies published between 2020 and 2025 were reviewed, highlighting progress in antimicrobial stewardship, non-antibiotic prophylaxis, targeted intravesical therapies, and biologically directed treatments. Options such as methenamine Hippurate, vaginal oestrogen, and immunostimulatory agents show benefit in preventing recurrence. Intravesical glycosaminoglycan and antibiotic instillations offer targeted alternatives when resistance limits systemic treatment. Newer approaches, including bacteriophage therapy, nanoparticle delivery systems, and microbiota-based interventions, show early promise. Evidence supports a shift toward precision-based UTI management with individualised patient care that prioritises prevention, targeted therapy, and reduced antibiotic exposure. Further robust studies with longer follow up are needed to define optimal pathways.