Urinary tract infections in therapist’s practice

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Abstract

Strategy and tactics of antimicrobial therapy for urinary tract infections (UTIs) have undergone significant changes in the last 10 years due to the global increase of infectious agents’ resistance to antibiotics. In the last decade, opinions on many seemingly unshakable truths in this area have changed. Now is accepted that urine is not sterile, but contains many microbes that make up the microbiome, while asymptomatic bacteriuria (ASB) is not considered to be a disease and in most cases is not treated. The UTI therapy strategy has changed: if in acute forms of this infection (cystitis, pyelonephritis) the aim is clinical and microbiological recovery, then in recurrent and chronic UTIs, therapy is aimed at reducing the frequency of relapses and lengthening the interrecurrent period, and it is allowed to achieve clinical recovery without microbiological, i.e. with the preservation of ASB. Rational choice of empiric antimicrobial therapy plays the main role in solving these problems. In addition, the strategy for the prevention and treatment of continuously recurrent UTIs has changed: previously used long-term courses of therapy with subtherapeutic doses of antimicrobials are currently not recommended due to the high risk of resistant microflora formation.

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Olga N. Sigitova

Kazan State Medical University of the Ministry of Healthcare of Russia; Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia

Author for correspondence.
Email: osigit@rambler.ru
ORCID iD: 0000-0001-8983-245X

MD, Professor of the Department of Polyclinic Therapy and General Medical Practice, Kazan State Medical University of the Ministry of Healthcare of Russia, Professor of the Department of Urology of Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia

Russian Federation, Kazan; Kazan

Alina R. Bogdanova

Kazan (Volga Region) Federal University

Email: _alinochka@mail.ru
ORCID iD: 0000-0001-6953-464X

PhD in Medical Sciences, Associate Professor of the Department of Internal Medicine

Russian Federation, Kazan

Milyausha I. Khasanova

Kazan State Medical University of the Ministry of Healthcare of Russia; Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia

Email: milyash@inbox.ru

PhD in Medical Sciences, Associate Professor of the Department of Urology and Nephrology, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia

Russian Federation, Kazan; Kazan

Taisiya Yu. Kim

Kazan State Medical University of the Ministry of Healthcare of Russia

Email: tais_ariana@mail.ru
ORCID iD: 0000-0003-2370-2972

PhD in Medical Sciences, Associate Professor of the Department of Polyclinic Therapy and General Medical Practice

Russian Federation, Kazan

Mikhail M. Batyushin

Rostov State Medical University of the Ministry of Healthcare of Russia

Email: batjushin-m@rambler.ru
ORCID iD: 0000-0002-5329-7050

MD, Professor of the Department of Internal Medicine No. 2

Russian Federation, Rostov-on-Don

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