Therapy of urinary tract infections

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Presentation transcript:

Therapy of urinary tract infections PharmDr. Ondřej Zendulka, Ph.D.

Urinary tract infections 2nd most common indication for ATB prescription Predispositions for uroinfections: woman morphologic abnormalities hormonal/metabolic disorder immunodeficiency Symptoms: urge to urinate, sharp pain, burning sensation Classification: 1. asymptomatic bacteriuria 2. acute uncomplicated cystitis 3. acute recurrent cystitis 4. acute non-gonococcal urethritis 5. acute uncomplicated pyelonephritis 6. recurrent pyelonephritis prostatitis, acute epididymitis kapavka - gonorrhoea

UTI pharmacotherapy overview Ethiology Frequency ATB therapy 1st choice ATB alternative ATB empiric therapy (based on characteristic symptoms of UTI) bacterial dominant always after urine sampling amoxicillin/clavulanate cephalosporins II. gen. co-trimoxazole* fluoroquinolones** cílená terapie (na základě průkazu původce a stanovení citlivosti k ATB) E. coli E coli. betalact. dominant pathogen always amoxicilin amoxicilin/cavulanate cefalosporiny II. gen Klebsiella pneu. less frequent Proteus mirab. amoxicillin amoxicillin/clavulanat Proteus sp. (indol+) rare Enterobacter s. other enterobacterias due to antibiogram enterococci