MP23-07 CLINICAL PRACTICE GUIDELINE:UNCOMPLICATED BACTERIAL COMMUNITY ACQUIRED URINARY TRACT INFECTION IN ADULTS—EPIDEMIOLOGY, DIAGNOSIS, TREATMENT, AND PREVENTION

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II1 Apr 2018MP23-07 CLINICAL PRACTICE GUIDELINE:UNCOMPLICATED BACTERIAL COMMUNITY ACQUIRED URINARY TRACT INFECTION IN ADULTS—EPIDEMIOLOGY, DIAGNOSIS, TREATMENT, AND PREVENTION Jennifer Kranz, Stefanie Schmidt, Cordula Lebert, Laila Schneidewind, Guido Schmiemann, and Florian Wagenlehner Jennifer KranzJennifer Kranz More articles by this author , Stefanie SchmidtStefanie Schmidt More articles by this author , Cordula LebertCordula Lebert More articles by this author , Laila SchneidewindLaila Schneidewind More articles by this author , Guido SchmiemannGuido Schmiemann More articles by this author , and Florian WagenlehnerFlorian Wagenlehner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.739AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Uncomplicated, bacterial, outpatient acquired urinary tract infections are among the most common infections in the outpatient area (prevalence 7.32%). The resistance level of these pathogens has increased considerably in recent years. This S3 guideline therefore contains up-to-date evidence for the rational use of antimicrobial substances, to avoid an inappropriate use of certain antibiotic classes and thus development of resistance. For the first time, recommendations on the prophylaxis of recurrent urinary tract infections are included. METHODS The guideline update was conducted by the German Society of Urology. A systematic literature search for the diagnosis, therapy and prevention of uncomplicated urinary tract infections was carried out in the databases Cochrane Library, Medline and Embase for the period 2008-2015, randomized controlled trials and systematic reviews with or without meta-analysis were included. Within the framework of a guideline synopsis, relevant guidelines were sought. Evidence level and bias risk were used for quality testing. RESULTS Particular emphasis is given to symptom-oriented diagnostics. Fosfomycin trometamol, nitrofurantoin, nitroxolin, pivmecillinam or trimethoprim are recommended equivalently for the treatment of uncomplicated cystitis. Fluoroquinolones and cephalosporins are not recommended. For uncomplicated slight-moderate pyelonephritis preferably the oral formulations namely cefpodoxim, ceftibuten, ciprofloxacin or levofloxacin are recommended. An asymptomatic bacteriuria is not to be treated. In recurrent urinary tract infections, non-antibiotic prevention measures are recommended. CONCLUSIONS Physicians, who are involved in the treatment of uncomplicated urinary tract infections, should familiarize themselves with the revised recommendations for the selection and dosage of antibiotic therapy of the updated clinical guideline. Antimicrobial stewardship aspects have significantly influenced the therapeutic recommendations. A broad implementation in all treatment groups is necessary to ensure a sustainable antibiotic policy and to improve care. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e283-e284 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jennifer Kranz More articles by this author Stefanie Schmidt More articles by this author Cordula Lebert More articles by this author Laila Schneidewind More articles by this author Guido Schmiemann More articles by this author Florian Wagenlehner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...