Guidance
This guideline sets out an antimicrobial prescribing strategy for preventing recurrent urinary tract infections in children, young people and adults who do not have a catheter. It aims to optimise antibiotic use and reduce antibiotic resistance.
Last reviewed: 12 December 2024
We reviewed the evidence and made new recommendations on methenamine hippurate as a preventative treatment. We also amended existing recommendations on referral and seeking specialist advice, oestrogen for prevention, and choice of antibiotic or antiseptic prophylaxis. For more details see the update information.
Next review: This guideline will be reviewed if there is new evidence that is likely to change the recommendations.
How we prioritise updating our guidance
Decisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process see NICE-wide topic prioritisation: the manual.
For information about individual topics, including any decisions affecting this guideline, see the summary table of prioritisation board decisions.
See a 3-page visual summary of the recommendations, including a table to support prescribing decisions.
NICE has also produced a guideline on antimicrobial stewardship: systems and processes for effective antimicrobial medicine use.
Recommendations
This guideline includes recommendations on:
- referral and seeking specialist advice
- treatments for preventing recurrent UTI
- choice of antibiotic or antiseptic prophylaxis
- self-care
Who is it for?
- Health professionals
- People with recurrent urinary tract infection, their families and carers
Guideline development process
How we develop NICE guidelines
NICE worked with Public Health England to develop this guidance.
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.