Antibacterial therapy of complicatedurinary infections in outpatients
- Authors: Rafalsky VV1, Strachunsky LS1, Kogan MI1, Petrov SВ1, Grinev AV1, Shevelev AN1
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Affiliations:
- Issue: No 5 (2004)
- Pages: 25-31
- Section: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/275557
- ID: 275557
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Abstract
The term complicated urinary infections (CUIs) includes infections
developing in the presence of anatomic anomalies, metabolic or
hormonal disorders, immunodeficiency or infection with atypical microorganisms.
Complicating factors diminish efficiency of antibiotic
treatment, raise probability of recurrence. CUIs account for 45.2% of
all cases of outpatient urinary infections in adults in Russia. Nephroliths,
diabetes meUitus and renal cysts are most prevalent complicating
factors. CUIs causative agents' spectrum is wider and resistance bacteria
isolation is more frequent compared to uncomplicated urinary infections.
In addition to antibiotic therapy, CUIs treatment should be
focused on detection and elimination of the complicating factor. If
complicating factors are unremovable, antibiotic therapy should be directed
to management of clinical symptoms of urinary infection, prevention
of complications and damage to renal parenchyma. CUIs demand
longer courses of antibiotics than uncomplicated urinary infections:
7-14 days in infection of the lower urinary tracts, at least 14 days
in infection of the upper urinary tracts and 4-6 weeks in failure of the
standard course. Fluoroquinolones are drugs of choice in adults.
developing in the presence of anatomic anomalies, metabolic or
hormonal disorders, immunodeficiency or infection with atypical microorganisms.
Complicating factors diminish efficiency of antibiotic
treatment, raise probability of recurrence. CUIs account for 45.2% of
all cases of outpatient urinary infections in adults in Russia. Nephroliths,
diabetes meUitus and renal cysts are most prevalent complicating
factors. CUIs causative agents' spectrum is wider and resistance bacteria
isolation is more frequent compared to uncomplicated urinary infections.
In addition to antibiotic therapy, CUIs treatment should be
focused on detection and elimination of the complicating factor. If
complicating factors are unremovable, antibiotic therapy should be directed
to management of clinical symptoms of urinary infection, prevention
of complications and damage to renal parenchyma. CUIs demand
longer courses of antibiotics than uncomplicated urinary infections:
7-14 days in infection of the lower urinary tracts, at least 14 days
in infection of the upper urinary tracts and 4-6 weeks in failure of the
standard course. Fluoroquinolones are drugs of choice in adults.
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