Recurrent urinary tract infections in women


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Abstract

Recurrent urinary tract infections (RUTIs) occur in 10-15% of reproductive-aged women and in 20% of menopausal women. Patients with a confirmed diagnosis of RUTIs in the acute phase are recommended to use antibiotic therapy, the choice of which is based on the results of inoculations, by taking into account the susceptibility of an uropathogen and on those of other laboratory tests. However, the primary goal in the treatment of patients with RUTIs is to prevent relapses. To prevent RUTIs, low-dose antibacterial drugs are used daily or post-coitally for 6-12 months. Randomized clinical trials (RCTs) show that antibiotic prophylaxis is very effective, but has significant disadvantages that limit its widespread use: toxicity (hepatotoxicity, nephrotoxicity, etc.), the development of intestinal and vaginal dysbiosis, and the emergence of resistant strains of microorganisms. Vaccination, the purpose of which is to stimulate systemic and local immune responses against the most common uropathogens is now an important area in the treatment of patients with RUTIs. Numerous RCTs have demonstrated that E. coli-derived cell extract preparations signif icantly reduce the recurrence of cystitis and improve quality of life in women with RUTIs in different age groups. Conclusion. Treatment of patients with RUTIs is not limited to the prescription of antibacterial agents in the acute period. The therapy should be performed for a long time and be aimed at preventing subsequent relapses.

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About the authors

Elena I. Ermakova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Department of Gynecological Endocrinology

Email: ermakova.health@mail.ru
PhD, Senior research staff

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