[Lower urinary tract infections: bacterial epidemiology and recommendations].
Lower urinary tract infection remains frequent particularly in women, despite improvement in therapeutic means. It seems likely to revisit bacterial epidemiology and therapeutic available strategies. To analyze elements in presence i.e. infecting bacteria and antibiotics still active or identification of acquired resistance mechanisms should permit to establish the evolution during the last 10 years. The study shows that bacterial epidemiology in urinary tract infection has not changed significantly, despite antibiotic selective pressure expected from overused antibiotics. However few enterobacteriaceae more resistant than Escherichia coli have emerged, but the latter remains predominant. Development of resistance has concerned Negram, amoxicillin and Augmentin, but several active molecules such as ciprofloxacin, Monuril remain available. Duration of treatments are still discussed but there is a tend toward short durations and even mono-doses. The control of lower urinary tract infections remains relatively easy provided that a good therapeutic choice is based on well documented bacteriologic data (infecting species susceptible to the available antibiotics).
Bergogne-Bérézin
Eugénie
E
Antibiotiques, Thérapeutique Antiinfectieuses, Elsevier Masson, Paris. berezbiol@aol.com
D000658:Amoxicillin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy; D005260:Female; D005578:Fosfomycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D011512:Proteus Infections / Q000188:drug therapy; D011513:Proteus mirabilis / Q000187:drug effects; D013997:Time Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D005578:Fosfomycin; D002939:Ciprofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin