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

2. 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

3. 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