Recurrent UTIs continue to be a challenging condition for patients and providers. As we better understand the pathophysiology of rUTIs, we can create more targeted therapies. It is increasingly evident that urine is not sterile, and we need to elucidate the relationship between the urinary microbiome and the host and pathogen factors that cause rUTIs. Furthermore, antibiotic stewardship will only strengthen the impetus to develop and study more nonantibiotic treatments and methods for prophylaxis. For example, UTI vaccines and host response modulation may have a large impact in the future.[18,19] The recent AUA Guidelines on rUTI have provided clinicians much needed advice on this topic, but at the same time it is clear that this is a rapidly evolving field as we try and stay one step ahead of the bacteria.
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Curr Opin Urol. 2020;30(6):833-837. © 2020 Wolters Kluwer Health, Inc.