{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:42:05Z","timestamp":1770079325618,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Recurrent urinary tract infection (rUTI) remains common and burdensome, with growing emphasis on antibiotic stewardship and non-antibiotic prevention. We characterized what women with rUTI know, do, and receive in everyday care and identified gaps between patient understanding and guideline-concordant management. Materials and Methods: We conducted a single-center, cross-sectional survey of consecutive adult women presenting with rUTI to a urology clinic in Poland. A structured questionnaire captured demographics, knowledge, symptoms and triggers, diagnostics, treatments and prevention, and satisfaction. Responses were standardized a priori; descriptive statistics and exploratory comparisons were performed (N = 36). Results: The mean age was 53.0 years (SD: 14.8). Only 36.1% identified the correct rUTI definition, while 83.3% recognized bacteria as the common cause. The symptom profile was dominated by frequency and dysuria (each 88.9%); 27.8% reported intercourse as a precipitant, and this was more frequent among sexually active women (43.5% vs. 7.7%; p = 0.031). Over half (55.6%) perceived no seasonality. The median number of episodes in the prior year was five (IQR 4\u20136). Urine culture was obtained before treatment in 38.9% and after treatment in 13.9%. The overall satisfaction with care was low to moderate (13.9% were very satisfied, 61.1% were moderately satisfied, and 25.0% were dissatisfied). Prior antibiotic exposure included ciprofloxacin (55.6%), furazidin (75.0%), and fosfomycin (47.2%). The uptake of preventive options was uneven: immunoactive vaccines accounted for 19.4%, methenamine hippurate for 16.7%, pelvic floor physiotherapy for 33.3%, and vaginal estrogen for 5.6% overall (9.5% among women \u2265 50 years). Conclusions: In this clinic-referred cohort, rUTI was frequent and disruptive, factual knowledge was limited, urine culture use was inconsistent, and fluoroquinolone exposure remained common. Preventive care was misaligned with guidelines, with underuse of vaginal estrogen and variable adoption of non-antibiotic strategies. Targeted education, stewardship, and structured access to evidence-based prevention may improve outcomes.<\/jats:p>","DOI":"10.3390\/medicina62020295","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T12:49:44Z","timestamp":1770036584000},"page":"295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Awareness to Action: Women\u2019s Self-Care Strategies and Clinical Behaviors in Recurrent Urinary Tract Infections"],"prefix":"10.3390","volume":"62","author":[{"given":"Laura","family":"Miszewska","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Medical University of Gda\u0144sk, ul. Smoluchowskiego 17 UCK, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7527-3692","authenticated-orcid":false,"given":"Kevin","family":"Miszewski","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, ul. Smoluchowskiego 17 UCK, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart\u0142omiej","family":"Marczak","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, ul. Smoluchowskiego 17 UCK, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Kucko","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Medical University of Gda\u0144sk, ul. Smoluchowskiego 17 UCK, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Matuszewski","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, ul. Smoluchowskiego 17 UCK, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/tcmj.tcmj_67_21","article-title":"Risk of urinary tract infection symptoms recurrence in women: A prospective observational study","volume":"34","author":"Chen","year":"2021","journal-title":"Tzu Chi Med. J."},{"key":"ref_2","unstructured":"European Association of Urology (2024). EAU Guidelines on Urological Infections, European Association of Urology. [2024 ed.]. Available online: https:\/\/uroweb.org\/guidelines\/urological-infections."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Maxwell, K., Roberts, L., Kramer, M., Price, J., Newlands, A., and Finlay, K.A. (2023). Psychosocial burden and healthcare disillusionment in recurrent urinary tract infection: A large-scale international survey of patient perspectives. Front. Urol., 3.","DOI":"10.3389\/fruro.2023.1264299"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.urology.2024.06.015","article-title":"Systematic review of the global literature on uncomplicated recurrent urinary tract infections in women: Underscoring major heterogeneity","volume":"191","author":"Papp","year":"2024","journal-title":"Urology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"BJGPO.2023.0224","DOI":"10.3399\/BJGPO.2023.0224","article-title":"General practitioners\u2019 decision making managing uncomplicated urinary tract infections in women: A qualitative study","volume":"8","author":"Kurotschka","year":"2024","journal-title":"BJGP Open"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1097\/JU.0000000000002860","article-title":"Updates to recurrent uncomplicated urinary tract infections in women: AUA\/CUA\/SUFU guideline","volume":"208","author":"Anger","year":"2022","journal-title":"J. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"124","DOI":"10.26719\/emhj.20.085","article-title":"Antibiotic resistance: A comparison between inpatient and outpatient uropathogens","volume":"27","author":"Akhavizadegan","year":"2021","journal-title":"East. Mediterr. Health J."},{"key":"ref_8","first-page":"CD001321","article-title":"Cranberries for preventing urinary tract infections","volume":"11","author":"Williams","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00345-013-1091-6","article-title":"D-mannose powder for prophylaxis of recurrent urinary tract infections in women: A randomized clinical trial","volume":"32","author":"Altarac","year":"2014","journal-title":"World J. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1001\/jamainternmed.2024.0264","article-title":"D-mannose for prevention of recurrent urinary tract infection among women: A randomized clinical trial","volume":"184","author":"Hayward","year":"2024","journal-title":"JAMA Intern. Med."},{"key":"ref_11","first-page":"EVIDoa2100018","article-title":"Sublingual MV140 for prevention of recurrent urinary tract infections in women: Randomized, double-blind, placebo-controlled trial","volume":"1","author":"Foley","year":"2022","journal-title":"NEJM Evid."},{"key":"ref_12","first-page":"373","article-title":"The Diagnosis, Treatment, and Prevention of Recurrent Urinary Tract Infection","volume":"121","author":"Schmiemann","year":"2024","journal-title":"Dtsch. \u00c4rzteblatt Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e26781","DOI":"10.2196\/26781","article-title":"Using large-scale social media analytics to understand patient perspectives about urinary tract infections: A thematic analysis","volume":"24","author":"Gonzalez","year":"2022","journal-title":"J Med. Internet Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1007\/s11136-023-03348-7","article-title":"Development and psychometric validation of the Recurrent UTI Impact Questionnaire (RUTIIQ)","volume":"32","author":"Newlands","year":"2023","journal-title":"Qual. Life Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1002\/nau.25426","article-title":"Evaluating the quality-of-life impact of recurrent urinary tract infection: Validation and refinement of the RUTIIQ","volume":"43","author":"Newlands","year":"2024","journal-title":"Neurourol. Urodyn."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/bju.15756","article-title":"Guideline of guidelines: Management of recurrent urinary tract infections in women","volume":"130","author":"Kwok","year":"2022","journal-title":"BJU Int."},{"key":"ref_17","first-page":"1209","article-title":"Postcoital antimicrobial prophylaxis for recurrent urinary tract infection","volume":"322","author":"Storm","year":"1990","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"9","DOI":"10.7326\/0003-4819-135-1-200107030-00004","article-title":"Patient-initiated treatment of uncomplicated recurrent urinary tract infections in young women","volume":"135","author":"Gupta","year":"2001","journal-title":"Ann. Intern. Med."},{"key":"ref_19","first-page":"315.e1","article-title":"Efficacy of vaginal estrogen for recurrent urinary tract infection prevention in hypoestrogenic women: A large cohort study","volume":"229","author":"Hotton","year":"2023","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_20","first-page":"20","article-title":"Vaginal estrogen for the prevention of recurrent urinary tract infection in postmenopausal women: A randomized clinical trial","volume":"27","author":"Mao","year":"2021","journal-title":"Female Pelvic Med. Reconstr. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"k678","DOI":"10.1136\/bmj.k678","article-title":"Fluoroquinolone Use and Risk of Aortic Aneurysm and Dissection: Nationwide Cohort Study","volume":"360","author":"Pasternak","year":"2018","journal-title":"BMJ"},{"key":"ref_22","first-page":"e0068229","article-title":"ALTAR: Methenamine hippurate versus daily antibiotics for prevention of recurrent UTIs\u2014A non-inferiority randomized trial","volume":"376","author":"Harding","year":"2022","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Nickel, J.C., and Doiron, R.C. (2023). An effective sublingual vaccine, MV140, safely reduces risk of recurrent urinary tract infection in women: Review. Pathogens, 12.","DOI":"10.3390\/pathogens12030359"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Barski, D., Finzer, P., Golka, K., Renner, O., Wirtz, R., Ecke, T., and Otto, T. (2025). Role of Vaginal Microbiota and Oral Lactobacillus Supplementation in Recurrent Urinary Tract Infections of Menopausal Women: Protocol for the VaMirUTI Cohort Study. Bioengineering, 12.","DOI":"10.3390\/bioengineering12111134"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1001\/jamainternmed.2018.4204","article-title":"Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: A randomized clinical trial","volume":"178","author":"Hooton","year":"2018","journal-title":"JAMA Intern. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/2\/295\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T13:24:10Z","timestamp":1770038650000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/2\/295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,2]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["medicina62020295"],"URL":"https:\/\/doi.org\/10.3390\/medicina62020295","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,2]]}}}