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Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025)
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Access FAQs on AUA clinical guideline usage and licensing.
By reading this guideline, you agree to AUA's Guidelines Terms and Conditions of Use.
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Access to AUA guidelines is provided free for individual clinical use only, in accordance with the AUA Guidelines Terms and Conditions of Use. Anyone accessing AUA guidelines for any other purpose must obtain a license/permission in advance. Licenses for academic, research and educational purposes (e.g., in course packs or employer-sponsored research) can be requested through the AUA by contacting permissions@AUAnet.org.
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Guideline Resources
Recurrent UTI Guideline PDF
Recurrent UTI Algorithm
Recurrent UTI Amendment Summary
(Published 2019, Reviewed and Validity Confirmed 2022, Amended 2025)
This document is endorsed by the American Urogynecologic Society.
Purpose
Over the past few decades, our ability to diagnose, treat, and manage recurrent urinary tract infection (rUTI) long-term has evolved due to additional insights into the pathophysiology of rUTI, a new appreciation for the adverse effects of repetitive antimicrobial therapy (“collateral damage”), rising rates of bacterial antimicrobial resistance, and better reporting of the natural history and clinical outcomes of acute cystitis and rUTI. This document seeks to establish guidance for the evaluation and management of patients with rUTIs to prevent inappropriate use of antibiotics, decrease the risk of antibiotic resistance, reduce adverse effects of antibiotic use, provide guidance on antibiotic and non-antibiotic strategies for prevention, and improve clinical outcomes and quality of life for women with rUTIs by reducing recurrence of UTI events.
Key Takeaways
For the purposes of this Guideline, the Panel considers only recurrent episodes of localized (restricted to the lower urinary tract) cystitis in women. This Guideline does not apply to individuals with complicating factors that place them at higher risk for development of a urinary tract infection (UTI) or for decreased efficacy of therapy as well as those with signs or symptoms of systemic bacteremia. Recommendations included in this Guideline discuss the following:
- Evaluation
- Asymptomatic bacteriuria
- Antibiotic treatment
- Antibiotic prophylaxis
- Non-antibiotic prophylaxis
- Follow-up evaluation
- Use of estrogen
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AUA Clinical Practice Guidelines are developed by multidisciplinary panels of experts based on rigorous systematic review of current urologic research.
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What is a Urinary Tract Infection (UTI) in Adults? |
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Recurrent UTI Guideline PDF |
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Recurrent UTI Algorithm |
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Recurrent UTI Amendment Summary |