The clinical management of
urinary tract infection has changed considerably over the last two decades due to the recognition of several important factors: All
urinary tract infections are not the same; in particular, deep tissue
infection of the kidney and/or prostate requires a very different form of clinical management than does superficial mucosal
infection of the bladder. Consistent with these differences, it is now clear that conventional 7-14 day treatment courses are not ideal for most forms of
urinary tract infections; deep tissue
infection requires more intensive
therapy and superficial mucosal
infection needs less intensive
therapy. In particular, single dose antimicrobial
therapy has been a major advance in the management of the most common form of
urinary tract infection--acute uncomplicated
urinary tract infection of the adult female; such
therapy is safe, effective, inexpensive, and the response provides useful clinical information. The recognition of the etiology of the acute urethral syndrome in most patients (true
bacteriuria or Chlamydia trachomatis
infection) had led to an effective therapeutic approach to this problem. A logical approach to the problem of recurrent
urinary tract infection has emerged that is both cost-effective and clinically effective. Finally, a clearer picture of those populations that would benefit most from anatomical study of the urinary tract has been developed. With these advances, this most common of
bacterial infections affecting man throughout his lifespan has become much easier to control.