Knowledge is Key: Viewpoints of New Recurrent Urinary Tract Infections Guidelines

Abstract

To evaluate management patterns, measure familiarity with the new guidelines, and gauge the level of education and confidence in treating rUTIs according to recent guidelines, specifically in the context of trainee education. Recurrent urinary tract infections (rUTI) are a common urologic complaint and a heavy burden on the healthcare system. Until recently, the AUA did not have a guideline on the management of rUTIs. Participants were medical students (PGY3-4, n=41), residents (n=48), and fellows (n=11) from a single institution (N=100) from both urology and non-urology backgrounds. This prospective survey study measured demographic information, personal history of rUTI management, knowledge of the new guideline, personal practice patterns, and guideline education. Trainees reported that they felt "slightly unknowledgeable" (M=2.6/4, P < .001) about rUTI treatment, although level of knowledge increased with increased training level. Participants were asked about the new rUTI guidelines that were published in 2019, with urology trainees (M=83.3%) more aware (P < .001) of their recent release compared to non-urology residents and fellows (M=12.2%) and medical students (M=7.5%). When looking specifically at peri- and postmenopausal women, antibiotic treatment was the highest recommendation for rUTI in both peri- (70.6%), and post-menopausal women (68.2%), followed by cranberry juice/extract (43.5% vs 42.4%). Providers were more likely to recommend vaginal estrogens for post-menopausal (45.9%) compared to perimenopausal (28.2%, P < .05) women. Better trainee education about the current rUTI guidelines is warranted, including management of peri- and postmenopausal women which have specific guideline recommendations.