
The study addressed recurrent lower urinary tract infections in women, highlighting the pressing need for comprehensive treatment guidelines. Among 1,582 studies, 74 met inclusion criteria, encompassing 49 trials, 23 systematic reviews, and 2 practice guidelines. Surprisingly, no study reported a multi-targeted treatment approach. The findings emphasize the lack of high-quality studies on prevention strategies. The proposed solution is an algorithmic approach integrating education, lifestyle modifications, and specific interventions. For postmenopausal women, vaginal estrogen with or without probiotics is suggested; low-dose post-coital antibiotics are recommended for premenopausal women with sexual activity-related infections, and daily prophylaxis for non-sexual activity-related cases. Nonantibiotic options like methenamine hippurate and lactobacillus-containing probiotics are also endorsed. Consistent terminology, validated assessment tools, and patient perspectives are recommended for future research, marking a significant stride in bridging the literature-practice gap.
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