2025/05/23 by Virgile Veyrat, Aurélien Dinh, Clara Duran +1 · 1 voice
Medicine · #Pelvic floor disorders treatments #Urinary Bladder and Prostate Research #Urinary Tract Infections Management
paper · doi:10.1093/cid/ciaf186
openalex created_date 2025/05/23 · openalex publication_date 2025/05/23 · openalex updated_date 2026/07/30
To the Editor—We read with great interest the State-of-the-Art Review “Recurrent Uncomplicated Urinary Tract Infections in Women” by Advani et al [1]. The authors are to be congratulated for their excellent and exhaustive review of a condition responsible for substantial antibiotic use, both for treatment and prophylaxis. Current guidelines recommend continuous low-dose antibiotic prophylaxis as the most studied strategy for preventing recurrent urinary tract infections (R-UTIs) [2]. Despite limited evidence, this approach remains widely used, though it carries a well-documented risk of emergence of antimicrobial resistance [3]. In our experience managing patients with neurogenic bladder, a population highly susceptible to R-UTIs, we have implemented a weekly oral cycling antibioprophylaxis (WOCA) strategy. This regimen involves the alternating administration of 2 different oral antibiotics, taken once weekly (every Sunday). On week A, patients receive antibiotic A; on week B, they receive antibiotic B, with the choice of agents based on prior urine cultures and patient tolerability [4,5].