Management of suspected bacterial lower urinary tract infection in adult women
Lower urinary tract infections are commonly-occurring and frequently self-limiting infections involving the bladder (cystitis) and urethra. Over a third of adult women in the UK report having had at least one urinary tract infection in their lifetime. In Scotland, UTIs are the most prevalent healthcare-associated infection within inpatient adult care and the second most commonly-reported indication for an antibiotic prescription in the community after respiratory tract infection. Rationalising and limiting unnecessary antibiotic use in patient with suspected (usually self-limiting) lower urinary tract infection is a crucial step in controlling antimicrobial resistance.
Remit and Target Users
This guideline provides recommendations based on current evidence for best practice in the diagnosis and management of suspected bacterial lower urinary tract infection in adult women. It replaces SIGN 88: Management of suspected bacterial urinary tract infection in adults which was first published July 2006 and updated in July 2012. This guideline includes younger women aged 16–64 years, older women aged 65 years and over and women of any age using an indwelling, intermittent or suprapubic catheter. It also includes the diagnosis and management of recurrent UTI in these groups.
This guideline does not cover the following:
- diagnosis and management of upper UTI,
- UTI in children under 16 years of age,
- UTI in pregnant women,
- UTI in men,
- interstitial cystitis and bladder pain syndrome.
The decision to focus on guidance for managing UTI symptoms in non-pregnant women of all ages was based on the burden of infection being in this population and the potential complicated nature of UTI in other populations.
This guideline will be of interest to healthcare professionals in primary and secondary care, officers in charge of residential and care homes, antibiotic policy makers, clinical effectiveness leads, carers and patients.
How this guideline was developed
This guideline was developed using a standard methodology based on a systematic review of the evidence. Further details can be found in SIGN 50: A Guideline Developer’s Handbook.
Keeping up to date
This guideline was published in 2020 and will be considered for review in three years. The review history, and any updates to the guideline in the interim period, will be noted in the review report.
Current 3-7 years
