Complex therapy of recurrent urinary infections

Abstract

Recurrent urinary tract infections (RUTI) occur in 10-15 % of women of reproductive age and in 20 % of menopausal women and have an extremely negative impact on quality of life. Urinary tract infections (UTIs) account for about 40 % of all hospital-acquired infections and 50% of bacterial infections resulting in long-term hospitalisation. In Russia, 26-36 million cases of acute cystitis are reported each year. Because of its high prevalence, UTI is an economic problem. Clinically, UTI is more often manifested as acute urethritis or cystitis. Antibiotic therapy is a fundamental treatment for RUTI, but has a number of negative consequences. Antimicrobial resistance is an enormous challenge and a serious threat to global health, prompting the search for alternative strategies. Natural antimicrobial peptides have attracted the attention of researchers and clinicians for their broad therapeutic potential against bacteria, viruses and resistant intracellular bacterial communities (biofilms). This review details the etiology, classification, diagnosis and therapy of RUTI. Global data revealing the mechanisms of action of antimicrobial peptides is presented. Commercially available peptide-based antimicrobials and their efficacy based on clinical trials are discussed. The development of new strategies to combat bacterial infections, in particular the use of drugs based on antimicrobial peptides and their derivatives, has been shown to be of great practical importance in terms of combating multidrug-resistant pathogens and increasing the effectiveness of treatment of recurrent infections.