Simplifying urinary tract infection management and prevention

+Practice

In print

Clinical update: UTIs

Simplifying urinary tract infection management and prevention

May 2025

By Noni Richards

Wednesday 30 April 2025, 12:35 AM

The classic symptoms of a lower urinary tract infection include dysuria, urinary frequency, urgency and suprapubic pain [Mintra Kwthijak on iStock]

Clinical writer Noni Richards summarises the assessment, treatment and prevention of urinary tract infections

Key points, Be aware of red flags, such as fever, flank pain, haematuria and recurrent infections. Urine culture is recommended for patients with urinary tract , Pract Green w Pale Yellow

Women's Health

References

1. Health Quality & Safety Commission. Atlas of Healthcare Variation: Community use of antibiotics. 8 November 2021.

2. Lewington A. Urinary tract infections in women. BMJ Best Practice, 19 February 2025.

3. BPACnz. Urinary tract infections (UTIs) – an overview of lower UTI management in adults. 10 December 2021.

4. He Ako Hiringa. Nitrofurantoin first for lower urinary tract infections. 31 March 2023.

5. Kularatne R. Diagnostic stewardship initiative for urinary tract infections. Awanui Labs, 5 July 2024.

6. Community HealthPathways – Auckland Region. UTI in adults. Accessed 9 March 2025.

7. Health New Zealand Te Whatu Ora Waitaha Canterbury. The Pink Book: Uncomplicated Acute Lower Urinary Tract Infections (Cystitis) in Women. February 2019.

8. New Zealand Formulary. NZF v153; 1 March 2025.

9. Awanui Labs Northern. Antimicrobial Susceptibility Report: Auckland and Northland community isolates 2023.

10. Awanui Labs. 2023 Awanui Labs Canterbury Community cumulative antibiotic susceptibilities (antibiogram). 2024.

11. Wang CH, Fang CC, Chen NC, et al. Cranberry-containing products for prevention of urinary tract infections in susceptible populations: a systematic review and meta-analysis of randomized controlled trials. Arch Intern Med 2012;172(13):988–96.

12. Harding C, Chadwick T, Homer T, et al. Methenamine hippurate compared with antibiotic prophylaxis to prevent recurrent urinary tract infections in women: the ALTAR non-inferiority RCT. Health Technol Assess 2022;26(23):1–172.

How to Treat

+How to treat

For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews

Wednesday 28 May 2025, 12:50 AM