Urinary tract infections: diagnosis and treatment, updates 2022
DOI:
https://doi.org/10.15574/HW.2023.164.64Keywords:
urinary tract infections, women, phosphomycin, urofoscinAbstract
Urinary tract infections (UTIs) are a common reason for seeking medical care and prescribing antimicrobials.
Purpose is to highlight the issues of diagnosis and treatment of UTIs, taking into account the updates of 2022.
The diagnostic aspects of UTIs are considered. Antibacterial and non-antibacterial measures for the treatment and prevention of UTIs are highlighted. The priority prescription of phosphomycin in the treatment and prevention of uncomplicated and complicated UTIs is substantiated. The advantages and disadvantages of telemedicine counselling for patients with UTI are shown.
To diagnose acute uncomplicated cystitis, a urine test is performed, and if acute pyelonephritis is suspected, a bacteriological urine test is performed.
To treat a patient with cystitis, oral nitrofurans (nitrofurantoin) or sulfamethoxazole/trimethoprim are prescribed, and if this is not possible, oral amoxicillin/clavulanic acid or intravenous aminoglycosides (single dose) are used.
The introduction of telemedicine into primary care can improve treatment outcomes for urological patients, but doctors prescribe urinalysis and urine bacteriology less frequently during e-visits compared to office visits, and prescribe antibiotics much more frequently.
Short-term treatment of symptomatic UTIs, continuous or intermittent low-dose antimicrobial prophylaxis with phosphomycin are recommended by guidelines from leading associations in Europe and the United States as anti-recurrent therapy to reduce the risk of future UTIs and improve the quality of life of women of all ages.
No conflict of interests was declared by the authors.
References
Anger J et al. (2022). Updates to Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline. Journal of Urology. 208: 536-541. https://doi.org/10.1097/JU.0000000000002860; PMid:35942788
Bonkat G, Bartoletti R, Bruyere F et al. (2022). EAU Guidelines on Urological Infections. URL: https://uroweb.org/guidelines/urological-infections#3_2.
Bouiller K, Zayet S, Lalloz P-E, Potron A et al. (2022). Efficacy and Safety of Oral FosfomycinTrometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales. Antibiotics. 11: 198. https://doi.org/10.3390/antibiotics11020198; PMid:35203801 PMCid:PMC8868337
Candel FJ, David MM, Barberán J. (2019). New perspectives for reassessing fosfomycin: applicability in current clinical practice. Rev Esp Quimioter. 32 (1): 1-7.
Corrales M, Corrales-Acosta E, Corrales-Riveros JG. (2022). Which Antibiotic for Urinary Tract Infections in Pregnancy? A Literature Review of International Guidelines. J Clin Med. 11 (23): 7226. https://doi.org/10.3390/jcm11237226; PMid:36498799 PMCid:PMC9740524
Díez-Aguilar M, Cantón R. (2019). New microbiological aspects of fosfomycin. Rev Esp Quimioter. 32 (1): 8-18.
Fajfr M, Balik M, Cermakova E, Bostik P. (2020). Effective Treatment for Uncomplicated Urinary Tract Infections with Oral Fosfomycin, Single Center Four Year Retrospective Study. Antibiotics (Basel). 9 (8): 511. https://doi.org/10.3390/antibiotics9080511; PMid:32823650 PMCid:PMC7459894
Falagas ME, Athanasaki F, Voulgaris GL et al. (2019). Resistance to fosfomycin: mechanisms, frequency and clinical consequences. Int. J. Antimicrob, Agen. 53 (1): 22-28. https://doi.org/10.1016/j.ijantimicag.2018.09.013; PMid:30268576
, Hernández-Hernández D, Ortega-González Y, Padilla-Fernández B et al. (2022). Management of Acute Cystitis in the Era of COVID-19. Curr Bladder Dysfunct Rep. 22: 1-6. https://doi.org/10.1007/s11884-022-00677-0; PMid:36466948 PMCid:PMC9684745
Jent P, Berger J, Kuhn A et al. (2022). Antibiotics for Preventing Recurrent Urinary Tract Infection: Systematic Review and Meta-analysis. Open Forum Infectious Diseases. 9 (7): ofac327. https://doi.org/10.1093/ofid/ofac327; PMid:35899289 PMCid:PMC9310516
Kwok M, McGeorge S, Mayer-Coverdale J et al. (2022). Guideline of guidelines: management of recurrent urinary tract infections in women. BJUI. https://doi.org/10.1111/bju.15756; PMid:35579121 PMCid:PMC9790742
Matthews PC, Barrett LK, Warren S et al. (2016). Oral fosfomycin for treatment of urinary tract infection: a retrospective cohort study. BMC Infect Dis. 16: 556. https://doi.org/10.1186/s12879-016-1888-1; PMid:27729016 PMCid:PMC5057270
McKertich К, Hanegbi U. (2021). Recurrent UTIs and cystitis symptoms in women AJGP. 50 (4): 199-205. https://doi.org/10.31128/AJGP-11-20-5728; PMid:33786541
MOZ Ukrainy. (2022). Standart medychnoi dopomohy «Ratsionalne zastosuvannia antybakterialnykh i antyfunhalnykh preparativ z likuvalnoiu ta profilaktychnoiu metoiu». Nakaz MOZ Ukrainy vid 18 travnia 2022 roku No.823.
Rubio EM, Martínez AR, Cruz AF. (2019). Fosfomycin in antimicrobial stewardship programs. Rev Esp Quimioter. 32 (1): 62-66.
Silver LL. (2017). Fosfomycin: mechanism and resistance. Cold Spring Harb. Perspect. Med. 1; 7 (2): a025262. https://doi.org/10.1101/cshperspect.a025262; PMid:28062557 PMCid:PMC5287057
Tutone М, Johansen T, Cai T, Mushtaq S, Livermore DM. (2022). SUsceptibility and Resistance to Fosfomycin and other antimicrobial agents among pathogens causing lower urinary tract infections: findings of the SURF study. International Journal of Antimicrobial Agents. 59 (5): 106574. https://doi.org/10.1016/j.ijantimicag.2022.106574; PMid:35307561
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