Інфекції сечової системи: діагностика та лікування, оновлення 2022 року

Abstract

Urinary tract infections (UTIs) are a common reason for seeking medical care and prescribing antimicrobials. Purpose is to highlight the issues of diagnosis and treatment of UTIs, taking into account the updates of 2022. The diagnostic aspects of UTIs are considered. Antibacterial and non-antibacterial measures for the treatment and prevention of UTIs are highlighted. The priority prescription of phosphomycin in the treatment and prevention of uncomplicated and complicated UTIs is substantiated. The advantages and disadvantages of telemedicine counselling for patients with UTI are shown. To diagnose acute uncomplicated cystitis, a urine test is performed, and if acute pyelonephritis is suspected, a bacteriological urine test is performed. To treat a patient with cystitis, oral nitrofurans (nitrofurantoin) or sulfamethoxazole/trimethoprim are prescribed, and if this is not possible, oral amoxicillin/clavulanic acid or intravenous aminoglycosides (single dose) are used. The introduction of telemedicine into primary care can improve treatment outcomes for urological patients, but doctors prescribe urinalysis and urine bacteriology less frequently during e-visits compared to office visits, and prescribe antibiotics much more frequently. Short-term treatment of symptomatic UTIs, continuous or intermittent low-dose antimicrobial prophylaxis with phosphomycin are recommended by guidelines from leading associations in Europe and the United States as anti-recurrent therapy to reduce the risk of future UTIs and improve the quality of life of women of all ages. No conflict of interests was declared by the authors.