Can a Silent Kidney Infection or Genetic Predisposition Underlie Recurrent UTIs?

, University of Calgary and Alberta Children's Hospital


Medscape General Medicine. 1996;1(1) 

In This Article

Managing a Relapse

Relapse is diagnosed by urine culture that documents the presence of bacteriuria with the same organism as that found in the initial infection. In general, most relapsing infections occur within 2-4 weeks after short-course therapy with antibiotics has been completed. Because many patients who develop recurrent infection have "silent" pyelonephritis,antibiotic treatment should be directed toward curing the kidney infection. A 14-day course of antibiotic treatment is given using the same standard doses for one of the drugs outlined in Table IV. Follow-up urinalysis and urine cultures arethen repeated 2 and 4 weeks after completing therapy. If symptoms recur within this time period and/or bacteriuria is again documented with the same organism, a prolonged 6-week course of antibiotics is then prescribed.[8] Although patientswith subclinical pyelonephritis can usually be managed with oral antibiotics, parenteral (IV) antibiotics may be prescribed as an outpatient therapy for the first 2 weeks of a prolonged treatment course, depending upon the microorganism and its susceptibility profile.