Advances in the understanding and treatment of urinary tract infections in young women.

Despite relative ease of management, the high rate of urinary tract infections (UTI) among young women presents substantial problems for the health care community. Although the majority of UTIs in young women are simple and uncomplicated, the rate of recurrence is substantial. Each treatment of UTI recurrence brings greater antibiotic resistance, requiring the use of broader spectrum and more expensive antibiotic therapy. Moreover, infection in patients with underlying urinary tract or systemic diseases can lead to serious medical and financial consequences. A better understanding of antibiotic resistance, particularly in regard to beta-lactamase-producing pathogens, has allowed us to develop more appropriate criteria for selecting antibiotics as well as the duration of therapy. The overall cost for treating UTIs in young women is a substantial health care expenditure, and requires an ongoing examination of new information concerning pathogenesis and available antibiotic therapies.