对于慢性复发性尿路感染 (UTI) ,并且经评估无泌尿系统异常的患者,可每天或性生活后使用抗生素预防性治疗(例如甲氧苄啶/磺胺甲噁唑或呋喃妥因)。性生活后排尿可能有帮助。[46]Foxman B, Frerichs RR. Epidemiology of urinary tract infection: II. Diet, clothing, and urination habits. Am J Public Health. 1985 Nov;75(11):1314-7.http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=4051067http://www.ncbi.nlm.nih.gov/pubmed/4051067?tool=bestpractice.com 长期使用呋喃妥因时应当谨慎,因为存在肺损伤的风险。[47]Santos JM, Batech M, Pelter MA, et al. Evaluation of the risk of nitrofurantoin lung injury and its efficacy in diminished kidney function in older adults in a large integrated healthcare system: a matched cohort study. J Am Geriatr Soc. 2016 Apr;64(4):798-805.http://www.ncbi.nlm.nih.gov/pubmed/27100576?tool=bestpractice.com
根据一项系统回顾,对于没有解剖异常的患者,短期预防性应用马尿酸乌洛托品可能有效。[48]Lee BS, Bhuta T, Simpson JM, et al. Methenamine hippurate for preventing urinary tract infections. Cochrane Database Syst Rev. 2012 Oct 17;(10):CD003265.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003265.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/23076896?tool=bestpractice.com
一些针对每日口服高剂量蔓越莓的研究发现,其片剂或提取物可使UTI发生率轻中度减低20%~30%,但是不同研究间结果不尽相同。[49]Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2012 Oct 17;(10):CD001321.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001321.pub5/fullhttp://www.ncbi.nlm.nih.gov/pubmed/23076891?tool=bestpractice.com[50]Wang CH, Fang CC, Chen NC, et al. Cranberry-containing products for prevention of urinary tract infections in susceptible populations: a systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2012 Jul 9;172(13):988-96.http://www.ncbi.nlm.nih.gov/pubmed/22777630?tool=bestpractice.com 如果患者想要尝试蔓越莓汁,医生不应阻止其饮食中添加合理剂量的蔓越莓汁。