Complications

Your Organisational Guidance

ebpracticenet urges you to prioritise the following organisational guidance:

Cystitis bij de vrouwPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2017La cystite chez la femmePublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 2017
Complication
Timeframe
Likelihood
short term
low

If left untreated in a susceptible patient, infection can spread up the urinary tract to the kidneys, resulting in a much more severe infection. Treatment will require a prolonged course of antibiotics for 10 to 14 days. Many patients will require hospitalisation and intravenous antibiotics.

Acute pyelonephritis

short term
low

Can result in preterm delivery or loss of the pregnancy.

Therefore, cystitis during pregnancy should be treated promptly. In addition, women are screened and treated for bacteriuria at the beginning of the pregnancy to prevent progression to pyelonephritis.​[1][22]

Overview of pregnancy complications

short term
low

Should resolve spontaneously. May require brief catheterisation.

variable
medium

A recurrent UTI may be complicated or uncomplicated, and is defined as at least 3 cases per year or 2 cases within 6 months.[1]

Due to the common occurrence of UTI, recurrence is to be expected. If recurrence occurs prior to 1 month, this may suggest incomplete eradication or an underlying abnormality predisposing to recurrent infections. In this situation urine culture is essential in identifying a causative pathogen and establishing its eradication.[8]​ In addition, if UTIs are occurring frequently then investigations for complicating factors should be considered.

Patient-initiated therapy for possible future episodes may also be considered. This is where the antibiotic prescription is given to the woman in advance of symptoms with detailed instructions on usage. Patient information brochures have been shown to help in this regard.[47]

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