Recurrent cystitis

≥ 3 episodes/ year or ≥ 2 episodes in 6 months

Recurrent cystitis can be either relapse or reinfection:

1. Relapse (same organism) - usually occurs within 2 weeks after completion of therapy. Consider investigation for pyelonephritis or renal abscess.

2. Re-infection - > 90% of recurrences are due to reinfection (same or different organism).

Within 1st month, it is difficult to differentiate between relapse and reinfection:

• A recurrent UTI with the same organism within a month should be treated as pyelonephritis . (i.e. with systemically active antibiotics and for longer than for cystitis)

• If recurrent UTI with a different organism within a month, treat as cystitis.