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How can recurrent urinary tract infection be treated?

Q: I am a 68 years old woman having recurrent urinary tract infection (UTI). The doctor has given me 4 short antibiotic treatments with Cipro for 3 days, over a period of 7 months. It was working fine for 4 to 6 weeks, then I suffered another UTI. Can a stronger antibiotic plan help? I am a type 2 diabetic for the last 7 years, with A1c levels at 6.2-6.5. I take Amaryl 1 mg and Metformin 500 mg thrice daily. Please advise.

A:Repeated urinary infections in postmenopausal females are not uncommon. Most originate due to perineal, urethral and vaginal changes secondary to lack of hormones (estrogen) following menopause. Primary line in such cases is to have a thorough urologic, gynaecologic and pelvic check, including abdominal and pelvic ultrasound, and PAP smear to exclude other organic causes for recurrent infections. If these examinations and tests exclude other causes, topical or systemic estrogen replacement therapy reverses the atrophic changes in due course. Prophylactic low dose antibiotics are usually not needed after 4 to 6 weeks of estrogen replacement therapy. Intermittent estrogen replacement therapy may, however, have to continue over long term to avoid infection recurrences.

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