What should be the initial course of action for a woman with a history of urinary tract infections?

The initial course of action for a woman with a history of urinary tract infections (UTIs) typically involves re-evaluating her urinary status, which includes checking her urine and potentially ordering a culture. This step is crucial because it helps to confirm the presence of a current infection and identify the specific bacteria responsible, thereby guiding appropriate treatment.

Rechecking the urine allows the healthcare provider to assess for the presence of nitrites, leukocyte esterase, and other indicators of infection. If a culture is ordered, it not only confirms the diagnosis but also provides sensitivity data that can dictate effective antibiotic therapy.

In cases of recurrent UTIs, understanding the specific microorganisms involved becomes particularly important to avoid inappropriate treatment and the risk of antibiotic resistance. Therefore, starting with a urinalysis and culture aligns well with evidence-based practice for managing recurrent urinary issues.

The other options may be relevant under certain circumstances but would typically not be the first step in management without prior confirmation of a current infection. For instance, imaging studies like an intravenous pyelogram or referral to a urologist are usually reserved for persistent or complicated cases, while evaluating for a possible kidney infection is more appropriate when a patient presents with severe symptoms, such as flank pain, fever, or