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Invited Commentary
Jan 14, 2013

New Perspectives on Urinary Tract Infection in Men
Comment on “Urinary Tract Infection in Male Veterans: Treatment Patterns and Outcomes” and on “Preoperative Urine Cultures at a Veterans Affairs Medical Center”

Author Affiliations

Author Affiliations: Section of Infectious Diseases, Health Services Research Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas.

JAMA Intern Med. 2013;173(1):68-70. doi:10.1001/jamainternmed.2013.1783

Most studies on the treatment of acute urinary tract infection (UTI) in outpatients have been performed in women, usually premenopausal women. The most recent treatment guidelines for acute, uncomplicated cystitis issued by the Infectious Diseases Society of America1 specifically exclude men from their recommendations, presumably for a lack of evidence to guide recommendations. The extensive literature on UTI in women recognizes that the pathogenesis, risk factors, and optimal management of UTI may differ by age and by menopausal status. We would expect similar distinctions in male UTI, particularly given the role of age-associated prostatic enlargement in urinary retention, but the available literature neither refutes nor supports this point. Recommendations for the treatment of male UTI generally state that 7 to 14 days of antibiotic therapy are required, without clear evidence to guide this statement.2

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