Managing urinary tract infections in midlife and older women

Urinary tract infections (UTIs) in women are common, bothersome, and linked to considerable costs for patients and health systems. Patients often experience adverse reactions with antibiotic therapy, and frequent antibiotic use for the treatment of UTIs is a major contributor to growing bacterial resistance to antibiotics worldwide. The development of antimicrobial resistance may limit future treatment options for the individual patient, as well as for the community. Nonantibiotic prevention offers the potential to limit these adverse consequences. Low-dose vulvovaginal estrogen therapy has an important role in preventing UTIs. In this Practice Pearl , UTI will refer to acute bacteria cystitis and associated symptoms.