Modern pharmacotherapy of uncomplicated infections of the lower urinary tract: the position of antibacterial and herbal preparations


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Abstract

Lower urinary tract infections (UTIs) are one of the most common types of infections in women. The existing high risk of recurrent forms, including relapses and reinfection, suggests the paramount importance of the pharmacotherapy strategy chosen by the doctor for the primary episode of lower urinary tract infection, especially acute cystitis, determining the degree of rehabilitation. Current data on the resistance of the main pathogens of UTI to many broad-spectrum antibacterial drugs, on the one hand, and the risk of subsequent resistance formation with the use of reserve antibiotics, such as fluoroquinolones, cephalosporins of 3-4 generation, on the other hand, make the search for optimal antibiotic therapy an urgent task for clinical pharmacologists, urologists and therapists. The article presents an analysis of current data on the prevalence and resistance of major pathogens and provides an review of international and Russian clinical recommendations for the management of patients with lower UTIs, especially acute cystitis, including an analysis of the positions of antibacterial and herbal drugs.

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About the authors

S. K Zyryanov

Peoples’ Friendship University of Russia; State budgetary institution of the city of Moscow «City Clinical Hospital No. 24 of the Department of Health of the city of Moscow»

Email: butranovaolga@mail.ru

O. I Butranova

Peoples’ Friendship University of Russia

Email: butranovaolga@mail.ru

A. Al-Ragawi

Peoples’ Friendship University of Russia

References

  1. Tan C.W., Chlebicki M.P. Urinary tract infections in adults. Singapore Med. J. 2016;57(9):485-490. doi: 10.11622/smedj.2016153.
  2. Hooton T.M., Scholes D., Hughes J.P. et al. A prospective study of risk factors for symptomatic urinary tract infection in young women. N Engl. J. Med. 1996;335(7):468-474. doi: 10.1056/NEJM199608153350703.
  3. Chu C.M., Lowder J.L. Diagnosis and treatment of urinary tract infections across age groups. Am. J. Obstet. Gynecol. 2018;219(1):40-51. doi: 10.1016/j.ajog.2017.12.231
  4. Ahmed H., Farewell D., Jones H.M. et al. Incidence and antibiotic prescribing for clinically diagnosed urinary tract infection in older adults in UK primary care, 2004-2014. PLoS One. 2018;13(1):e0190521. doi: 10.1371/journal. pone.0190521
  5. Azami M., Jaafari Z., Masoumi M. et al. The etiology and prevalence of urinary tract infection and asymptomatic bacteriuria in pregnant women in Iran: a systematic review and Meta-analysis. BMC Urol. 2019;19(1):43. doi: 10.1186/s12894-019-0454-8.
  6. Shaikh N., Morone N.E., Bost J.E., Farrell M.H. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr. Infect. Dis J. 2008;27(4):302-308. doi: 10.1097/INF.0b013e31815e4122.
  7. Alos J.I. Epidemiology and etiology of urinary tract infections in the community. Antimicrobial susceptibility of the main pathogens and clinical significance of resistance. Enferm. Infecc. Microbiol Clin. 2005;23(Suppl. 4):3-8. doi: 10.1157/13091442.
  8. Jhang J.F., Kuo H.C. Recent advances in recurrent urinary tract infection from pathogenesis and biomarkers to prevention. Ci Ji Yi Xue Za Zhi. 2017;29(3):131-137. doi: 10.4103/tcmj.tcmj_53_17.
  9. Рафальский В.В. Антибиотикорезистентность возбудителей неосложненных инфекций мочевых путей в Российской Федерации. Вестник урологии. 2018;6(3):50-56. https://doi.org/10.21886/2308-6424-2018-6-3-50-56
  10. Кузьменков А.Ю., Трушин И.В., Авраменко А.А. и др. AMRmap: интернет-платформа мониторинга антибиотикорезистентности. Клиническая микробиология и антимикробная химиотерапия. 2017;19(2):84-90
  11. Виноградова А.Г., Кузьменков А.Ю. Практическое применение AMRmap: элементы подхода «от общего к частному» на примере Klebsiella pneumoniae. Клиническая микробиология и антимикробная химиотерапия. 2019;(21)2: 181-186. Doi: 10.36488/ cmac.2019.2.181-186). doi: 10.36488/cmac.2019.2.181-186.
  12. Козлов Р.С., Палагин И.С., Голуб А.В. Пероральные цефалоспорины III поколения при внебольничных инфекциях мочевых путей: современные аспекты применения. Клиническая микробиология и антимикробная химиотерапия. 2019;21(3):225-228). doi: 10.36488/cmac.2019.3.225-228.
  13. Палагин И.С., Сухорукова М.В. Дехнич А.В. и др. Антибиотикорезистентность возбудителей внебольничных инфекций мочевых путей в России: результаты многоцентрового исследования «ДАРМИС-2018». КМАХ. 2019;21(2):134-146). doi: 10.36488/cmac.2019.2.134-146.
  14. Mysorekar I.U., Hultgren S.J. Mechanisms of uropathogenic Escherichia coli persistence and eradication from the urinary tract. Proc. Natl. Acad. Sci. USA. 2006;103(38):14170-14175. doi: 10.1073/pnas.0602136103.
  15. Rosen D.A., Hooton T.M., Stamm W.E. et al. Detection of intracellular bacterial communities in human urinary tract infection. PLoS Med. 2007;4(12):e329. doi: 10.1371/journal.pmed.0040329.
  16. https://www.ecdc.europa.eu/en/publications-data/surveillance-antimicrobial-resistance-europe-2018
  17. Bonkat G., Pickard R., Bartoletti R. et al. The Netherlands: European Association of Urology; 2018. EAU Guidelines on Urological Infections. Limited update March 2018. Available from: https://uroweb.org/ wp-content/uploads/EAU-Guidelines-on-Urological-Infections-2018-large-text.pdf
  18. https://www.nice.org.uk/guidance/ng109/evidence/evidence-review-pdf-6545836765/
  19. Scottish Intercollegiate Guidelines Network (SIGN). Management of suspected bacterial urinary tract infection in adults. Edinburgh: SIGN; 2012. (SIGN publication no. 88). [July 2012]. Available from URL: http:// www.sign.ac.uk
  20. Holm A., Cordoba G., Aabenhus R. Prescription of antibiotics for urinary tract infection in general practice in Denmark. Scand. J. Prim. Health Care. 2019;37(1):83-89. doi: 10.1080/02813432.2019.1569425
  21. Kranz J., Schmidt S., Lebert C. The 2017 Update of the German Clinical Guideline on Epidemiology, Diagnostics, Therapy, Prevention, and Management of Uncomplicated Urinary Tract Infections in Adult Patients. Part II: Therapy and Prevention. Urol. Int. 2018;100(3):271-278. doi: 10.1159/000487645
  22. Gupta K., Hooton T.M., Naber K.G. et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin. Infect. Dis. 2011;52(5):e103-120. doi: 10.1093/cid/ciq257
  23. Kang C.I., Kim J., Park D.W. et al. Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections. Infect. Chemother. 2018;50(1):67-100. doi: 10.3947/ic.2018.50.1.67
  24. https: //www.auanet.org/guidelines/recurrent-uti
  25. https://www.ooorou.ru/ru/page/rcr.html
  26. Перепанова Т.С. Федеральные клинические рекомендации «Антимикробная терапия и профилактика инфекций почек, мочевыводящих путей и мужских половых органов - 2015 г.». Терапевтический архив. 2016;4:100-104). Doi: 10.17116/ terarkh2016884100-104.
  27. Zhanel G.G., Walkty A.J., Karlowsky J.A. Fosfomycin: A First-Line Oral Therapy for Acute Uncomplicated Cystitis. Can. J. Infect. Dis. Med. Microbiol. 2016;2016:2082693. doi: 10.1155/2016/2082693.
  28. Crellin E., Mansfield K.E., Leyrat C. et al. Trimethoprim use for urinary tract infection and risk of adverse outcomes in older patients: cohort study. BMJ. 2018;360:k341. doi: 10.1136/bmj.k341.
  29. Fransen F., Melchers M.J.B., Lagarde C.M.C. et al. Pharmacodynamics of nitrofurantoin at different pH levels against pathogens involved in urinary tract infections. J. Antimicrob. Chemother. 2017;72(12):3366-3373. doi: 10.1093/jac/dkx313.
  30. Yang L., Wang K., Li H. et al. The influence of urinary pH on antibiotic efficacy against bacterial uropathogens. Urology. 2014;84(3):731.e 1 -7. doi: 10.1016/j.urology.2014.04.048.
  31. Dewar S., Reed L.C., Koerner R.J. et al. Emerging clinical role of pivmecillinam in the treatment of urinary tract infection in the context of multidrug-resistant bacteria. J. Antimicrob. Chemother. 2014;69(2):303- 308. doi: 10.1093/jac/dkt368/
  32. Babiker A., Clarke L., Doi Y., Shields R.K. Fosfomycin for treatment of multidrug-resistant pathogens causing urinary tract infection: A real-world perspective and review of the literature. Diagn. Microbiol. Infect. Dis. 2019;95(3):114856. doi: 10.1016/j.diagmicrobio.2019.06.008.
  33. Jansaker F., Th0nnings S., Hertz F.B. et al. Three versus five days of pivmecillinam for community-acquired uncomplicated lower urinary tract infection: A randomised, double-blind, placebo-controlled superiority trial. EClinical Medicine. 2019;12:62-69. doi: 10.1016/j.eclinm.2019.06.009.
  34. Huttner A., Verhaegh E.M., Harbarth S. et al. Nitrofurantoin revisited: a systematic review and meta-analysis of controlled trials. J. Antimicrob. Chemother. 2015;70(9):2456-2464. doi: 10.1093/jac/dkv147.
  35. Sadler S., Holmes M., Ren S. et al. Cost-effectiveness of antibiotic treatment of uncomplicated urinary tract infection in women: a comparison of four antibiotics. BJGP Open. 2017;1(3):bjgpopen17X101097. Doi:10.3399/ bjgpopen17X101097.
  36. Pujades-Rodriguez M., West R.M., Wilcox M.H., Sandoe J. Lower Urinary Tract Infections: Management, Outcomes and Risk Factors for Antibiotic Re-prescription in Primary Care. EClinicalMedicine. 2019;14:23-31. doi: 10.1016/j.eclinm.2019.07.012.
  37. Ahmed H., Davies F., Francis N. et al. Long-term antibiotics for prevention of recurrent urinary tract infection in older adults: systematic review and meta-analysis of randomised trials. BMJ Open. 2017;7(5):e015233. doi: 10.1136/bmjopen-2016-015233.

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