Recurrent cystitis in young women

A. Up to 20 percent of young women with acute cystitis develop recurrent UTIs. The causative organism should be identified by urine culture.

B. Women who have more than three UTI recurrences within one year can be managed using one of three preventive strategies.

1. Acute self-treatment with a three-day course of standard therapy.

2. Postcoital prophylaxis with one-half of a trimethoprim-sulfamethoxazole double-strength tablet (40/200 mg).

3. Continuous daily prophylaxis for six months with trimethoprim-sulfamethoxazole, one-half tablet per day (40/200 mg); nitrofurantoin, 50 to 100 mg per day; norfloxacin (Noroxin), 200 mg per day; cephalexin (Keflex), 250 mg per day; or trimethoprim (Proloprim), 100 mg per day.

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