- •1. Introduction
- •1.1 Classification
- •1.2 References
- •2.2 Background
- •2.3 Definition
- •2.4 Aetiological spectrum
- •2.5 Acute uncomplicated cystitis in pre-menopausal, non-pregnant women
- •2.8 UtIs in pregnancy
- •2.9 UtIs in post-menopausal women
- •2.11 References
- •19. Roberts fj.
- •27. Sanford jp.
- •28. Kinane df, Blackwell cc, Brettle rp, Weir dm, Winstanley fp, Eltor ra.
- •32. Nicolle le, Harding gkm, Preiksaitis j, Ronald ar.
- •50. Wadland wc, Planten da.
- •60. Vorland lh, Carlson k, Aalen odd.
- •3.2 Background
- •3.3 Aetiology
- •3.4 Pathogenesis
- •3.5 Signs and symptoms
- •3.7 Schedule of investigation
- •If findings indicate pathology
- •3.9 References
- •21. Jantausch pa, Rifai n, Getson p, Akrem s, Majd m, Wiedermann bl.
- •32. Rushton hg, Majd m, Jantausch b, Wiedermann l, Belman ab.
- •43. Kleinman pk, Diamond ba, Karellas a, Spevak mr, Nimkin k, Belenguer p.
- •4.2 Background
- •4.3 What are the acute effects of a uti on the kidney and do the lesions become chronic? Can they be prevented?
- •4.7 References
- •5.2 Definitions and classification
- •5.4 Treatment
- •5.5 Conclusions
- •5.6 References
- •6.2 Background
- •6.3 Definition and clinical manifestation of sepsis syndrome in urology
- •6.4 Physiology and biochemical markers
- •6.5 Prevention
- •6.6 Treatment of underlying disease
- •6.7 Conclusion
- •6.8 References
- •7.7 Therapy
- •7.8 Prevention
- •8.2 Prostatitis
- •8.3 Epididymitis and orchitis
- •8.4 References
- •1. Meares em, Stamey та.
- •2. Weidner w, Schiefer hg, Krauss h, Jantos Ch, Friedrich hj, Altmannsberger m.
- •3. Schaeffer aj.
- •8. Alexander rb, Ponniah s, Hasday j, Hebel jr.
- •26. Barbalias ga, Nikiforidis g, Liatsikos en.
- •27. Mayersak js.
- •28. Jimenez Cruz jf, Boronat f, Gallego j.
- •33. Naber kg, Weidner w.
- •9. Peri-operative antibacterial prophylaxis in urology
- •9.1 Summary
- •9.2 Introduction
- •9.3 Goals of peri-operative antibacterial prophylaxis
- •9.4 Indications for peri-operative antibacterial prophylaxis
- •9.5 Timing and duration of peri-operative antibacterial prophylaxis
- •9.6 Choice of antibiotics
- •9.7 Mode of application
- •9.8 Recommendations according to type of urological intervention
- •9.10 References
- •1. Rubin rh, Shapiro ed, Andriol vt, Davies rj, Stamm we.
- •3. Naber kg.
- •3. Recommendations for peri-operative antibacterial prophylaxis in urology (modified according to ref 1)
- •4. Antibacterial agents
- •4.1 Penicillins
- •4.2 Parenteral cephalosporins
- •4.3 Oral cephalosporins
- •4.4 Monobactams
- •4.5 Carbapenems
- •4.6 Fluoroquinolones
- •4.7 Macrolides
- •4.8 Tetracyclines
- •4.9 Aminoglycosides
- •4.10 Glycopeptides
- •4.11 References
1. Rubin rh, Shapiro ed, Andriol vt, Davies rj, Stamm we.
Evaluation of new anti-infective drugs for the treatment of UTI. Clin Infect Dis 1992; 15 (Suppl 1): S216-S227.
2. Rubin RH, Shapiro ED, Andriol VT, Davies RJ, Stamm WE, with modifications by a European Working Party (Norrby SR).
General guidelines for the evaluation of new anti-infective drugs for the treatment of UTI. Taufkirchen, Germany: The European Society of Clinical Microbiology and Infectious Diseases, 1993; 294-310.
3. Naber kg.
Experience with the new guidelines on evaluation of new anti-infective drugs for the treatment of urinary tract infections. Int J Antimicrob Agents 1999; 11:189-196.
|
2. Recommendations for antimicrobial 1 |
herapy in urology (modified according to ref 1) | ||
|
Diagnosis |
Most frequent |
Initial, empirical antimicrobial |
Therapy duration |
|
|
pathogen |
therapy |
|
|
Cystitis acute, |
• Escherichia coli |
• Trimethoprim-sulphamethoxazole |
1 -3 days |
|
uncomplicated |
• Klebsiella |
• Fluoroquinolone* |
|
|
|
• Proteus |
Alternatives: |
|
|
|
• Staphylococcus |
• Fosfomycin trometamol |
|
|
|
|
• Pivmecillinam |
|
|
|
|
• Nitrofurantoin |
|
|
Pyelonephritis |
• E. coli |
• Fluoroquinolone* |
7-10 days |
|
acute, |
• Proteus |
• Cephalosporin (group 2 or 3a) |
|
|
uncomplicated |
• Klebsiella |
Alternatives: |
|
|
|
• Other Enterobacteria |
• Aminopenicillin/BLI |
|
|
|
• Staphylococcus |
• Aminoglycoside |
|
|
UTI with |
• E. coli |
• Fluoroquinolone* |
3-5 days after |
|
complicating |
• Enterococcus |
• Aminopenicillin/BLI |
defeverescence or |
|
factors |
• Pseudomonas |
• Cephalosporin (group 2) |
control/elimination |
|
|
• Staphylococcus |
• Cephalosporin (group 3a) |
of complicating |
|
Nosocomial UTI |
• Klebsiella |
• Aminoglycoside |
factor |
|
|
• Proteus |
In case of failure of initial therapy |
|
|
Pyelonephritis |
• Enterobacter |
within 1-3 days or in clinically severe |
|
|
acute, |
• Other Enterobacteria |
cases: |
|
|
complicated |
• (Candida) |
Anti-Pseudomonas active: |
|
|
|
|
• Fluoroquinolone, if not used initially |
|
|
|
|
• Acylaminopenicillin/BLI |
|
|
|
|
• Cephalosporin (group 3b) |
|
|
|
|
• Carbapenem |
|
|
|
|
• + Aminoglycoside |
|
|
|
|
In case of Candida |
|
|
|
|
• Fluconazole |
|
|
|
|
• Amphotericin В |
|
|
Prostatitis |
• E. coli |
• Fluoroquinolone* |
Acute: |
|
acute, chronic |
• Other Enterobacteria |
Alternative in acute bacterial prostatitis: |
2 weeks |
|
|
• Pseudomonas |
• Cephalosporin (group 2) |
|
|
Epididymitis |
• Enterococcus |
• Cephalosporin (group 3a/b) |
Chronic: |
|
acute |
• Staphylococcus |
In case of Chlamydia or Ureaplasma: |
4-6 weeks or longer |
|
|
• Chlamydia |
• Doxycycline |
|
|
|
• Ureaplasma |
• Macrolide |
|
|
Urosepsis |
• E. coli |
• Cephalosporin (group 3a/b) |
3-5 days after |
|
|
• Other Enterobacteria |
• Fluoroquinolone* |
defeverescence or |
|
|
After urological interven- |
• Anti-Pseudomonas active |
control/elimination |
|
|
tions - multi-resistant |
acylaminopenicillin/BLI |
of complicating |
|
|
pathogens: |
• Carbapenem |
factor |
|
|
• Pseudomonas |
• ± Aminoglycoside |
|
|
|
• Proteus |
|
|
|
|
• Serratia |
|
|
|
|
• Enterobacter |
|
|
BLI = p-lactamase inhibitor; UTI = urinary tract infection. 'Fluoroquinolone with mainly renal excretion.
REFERENCES
1. Naber K, Funfstuck R, Hofstetter A, Briihl P, Hoyme U.
Empfehlungen zur antimikrobiellen Therapie von Infektionen der Nieren und der Urogenital traktes bei Erwachsenen. Chemotherapie Journal 2000; 9:193-199)