Continuing Medical Education (CME)

Urinary Tract Infection in Adult Women

Introduction to this self-study CME activity

Purpose

Urinary tract infection (UTI) has a high incidence in adult women. It is often not managed cost effectively, with laboratory tests performed that do not affect the management or outcome of treatment. This self-study activity provides practical guidance to primary care clinicians concerning a cost-effective management strategy for uncomplicated UTI in women. Key aspects of care include:

• Pretreatment cultures are rarely necessary for uncomplicated UTI.
• Consider telephone management for uncomplicated UTI in women with previous UTI.
• With stable rates of resistance in our community (15%-16%), TMP/SMX remains the drug of first choice in uncomplicated UTI in women. Three days of treatment with Bactrim or Cipro (7 days of macrobid or amoxicillin) is usually sufficient for uncomplicated UTI.
• Follow up cultures or urinalysis are not usually necessary.

This 2005 update of the guideline also addresses the following points:

• When resistance rates are less than 10-20%, TMP/SMX remains the most cost-effective therapy.
• Recommending alternative forms of contraception is not necessary when prescribing antibiotics for UTI in women using oral contraceptives (OCPs).
• Some studies have shown that cranberry juice or cranberry tablets can significantly reduce the annual incidence of UTIs in sexually active women with a history of UTIs.

Audience

This self-study activity is appropriate for primary care clinicians and other health care providers treating adults with urinary tract infection.

Authors

Team Leader
	Steven E. Gradwohl, MD General Internal Medicine
Team Members
	Carol E. Chenoweth, MD Infectious Diseases Karen R. Fonde, MD Family Medicine R. Van Harrison, PhD Medical Education Lauren B. Zoschnick, MD Obstetrics & Gynecology
Author Disclosures
	None of the authors have relationships with companies whose products are discussed in this guideline.

Other Acknowledgements

UMHS Guidelines Oversight Team: William E. Chavey, MD R. Van Harrison, PhD Connie J. Standiford, MD Literature search services: Taubman Medical Library Production of Internet format and web site maintenance: Ellen Patrick-Dunlavey, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was released in June 2005, with credit available through May 2008. This activity was reviewed for currency of content in April 2008 and availability of credit extended through April 2011.

Method of Participation

1. View the web pages. You may print the self-study text to read off-line.
2. Complete the on-line learning assessment test.  It will be electronically scored and the correct answers returned immediately for your review.
3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
4. Print the certificate of participation for your personal records.

 

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