Recurrent Urinary Tract Infections in Women: Current Management Guidelines and Therapeutic Options

Recurrent urinary tract infections (rUTIs) are a common clinical problem affecting women worldwide. These infections significantly impair the quality of life, impacting social and sexual relationships, self-esteem, and work productivity. The escalating global threat of antimicrobial resistance necessitates a shift from repetitive antibiotic use toward effective non-antimicrobial preventive strategies. The objective of this literature review is to summarize the latest diagnostic and management guidelines (2023-2026) for rUTI in women, with a particular focus on comparing recommendations from international (European Association of Urology, American Urological Association/Canadian Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction) and Polish (Polish Urological Association, Polish Society of Gynecologists and Obstetricians, Polish Society of Family Medicine) scientific societies. A literature review was performed based on current guidelines and recent clinical studies. The literature selection involved databases such as PubMed/MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Google Scholar. This review summarizes current recommendations for the diagnosis, prevention, and management of rUTIs in women. Antibiotic and non-antibiotic preventive strategies are discussed, including vaginal estrogen, methenamine hippurate, immunoactive prophylaxis, D-mannose, and cranberry products. Differences and similarities between international and Polish guidelines are highlighted. Management of rUTI requires a personalized, stepwise approach prioritizing behavioral modifications and non-antibiotic interventions. Clinicians must balance treatment efficacy with antimicrobial stewardship to mitigate collateral damage to the host microbiome.