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Lower urinary tract infection in non-pregnant women under 65

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Urinary system UTIs can be uncomfortable and distressing for patients who experience them

Urinary tract infection is common in women and women who develop a urinary tract infection (UTI) are likely to seek treatment in primary care or in NHS Walk in centres. Most women are prescribed antibiotics on the day they seek care1. In the UK UTIs are the second most common reason for antibiotic prescribing2, 3.

It is important to diagnose urinary tract infection as research indicates that misdiagnosis is common and urine culture indicates that only 24-66% of women in the UK treated with an antibiotic have a confirmed UTI4,5.Inappropriate antibiotic prescribing increases the risk of antibiotic resistance1. This article aims to enable readers to diagnose urinary tract infection appropriately, to consider alternative diagnoses and to manage and treat urinary tract infection in women under 65 years of age who are not pregnant.

What is a lower UTI

NICE defines lower urinary tract infection as: ‘An infection of the bladder usually caused by bacteria from the gastrointestinal tract entering the urethra and travelling up to the bladder.’6

The European Association of Urology categorises urinary tract infections based on clinical presentation and, anatomical level of the UTI, the grade of severity of the infection, the categorisation of risk factors classification of UTI is shown in Table one7.

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