Urinary Tract Infection: A Multimodal Approach to Management

Urinary tract infections (UTIs) are highly prevalent, resulting in 7 million outpatient visits, 1 million emergency department visits, and 100,000 hospitalizations annually.They predominantly affect females aged 20-50.Antibiotics are the primary treatment, but about 30% of treated females experience recurrence (rUTI).Regular antibiotic use also increases the risk of antibiotic resistance and side effects.Moreover, antibiotics can cause dysbiosis of the intestinal and vaginal flora, increasing the risk of recurrence.Therefore, nonantibiotic treatments are worth considering reducing antibiotic use and side effects.Nonantibiotic options such as cranberry juice, D-mannose, probiotics, and potassium magnesium citrate can alleviate UTI symptoms and reduce recurrence risk.Studies indicate that combining these non-antibiotic treatments, which work through different mechanisms, leads to better clinical outcomes.This review explores the role of each nonantibiotic treatment, the rationale for their combination, and supports their effectiveness with clinical evidence.Thus, the combination of non-antibiotic treatments may provide a better outcome for patients with UTI and rUTI.