A. Up to 20 percent of young women with acute cystitis develop recurrent UTIs. During these recurrent episodes, the causative organism should be identified by urine culture. Multiple infections caused by the same organism require longer courses of antibiotics and possibly further diagnostic tests. Most recurrent UTIs in young women are uncomplicated infections caused by different organisms. Women who have more than three UTI recurrences within one year can be managed using one of three preventive strategies:
1. Acute self-treatment with a three-day course of standard therapy.
2. Postcoital prophylaxis with one-half of a trimethoprim-sulfamethoxazole double-strength tablet (40/200 mg) if the UTIs have been clearly related to intercourse.
3. Continuous daily prophylaxis for six months: Trimeth-oprim-sulfamethoxazole, one-half tablet/day (40/200 mg); norfloxacin (Noroxin), 200 mg/day; cephalexin (Keflex), 250 mg/day.
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