Clinical investigations from the RACP

How to investigate recurrent urinary tract infections

Peter G Kerr, Susan Blair



Recurrent urinary tract infections (RUTIs) are a common problem in general practice and their investigation is aimed at identifying and reversing predisposing factors and avoiding complications.

Key Points

  • Most patients with recurrent urinary tract infections (RUTIs) will be adult women with anatomically normal urinary tracts who have no adverse renal outcomes and do not require extensive or repeated investigation.
  • An underlying cause for RUTIs is more likely in men and children, and additional investigation is therefore required in these patients.
  • All patients presenting with RUTIs should be screened for type 2 diabetes.
  • Asymptomatic bacteriuria does not require investigation or treatment unless the patient is pregnant or undergoing urinary tract instrumentation or surgery.
  • Management involves behavioural strategies, reversal of underlying causes where possible, and judicious use of antibiotic strategies.