Recurrent UTI – prevention (women)
Women with ≥2 UTIs in 6 months or ≥3 in 12 months, under clinician guidance.
women
urinary
Reduce frequency of recurrent UTIs
Core stack
Cranberry standardized to PAC-A
B
Form: extract
Dose: 36 mg PAC-A/day (or equivalent per product)
once daily with water
6–12 months, then reassess
Why: Cochrane 2023 shows significant reduction in recurrences; AUA conditionally recommends in rUTI.
Cautions
- Potential interaction with warfarin (rare—monitor INR)
- Possible dyspepsia
Adjuncts
Probiotics (L. rhamnosus GR-1 + L. reuteri/fermentum RC-14)
C
Dose: ≥1×10^9 CFU/day orally and/or intravaginally for 6 months
Not recommended
- D-mannose monotherapy: Large RCT (JAMA Intern Med 2024) did not show efficacy for rUTI prevention.
Monitoring
- UTI episode log
- Hydration; post-coital voiding habits