UTI \u2212 quo vadis? New alternatives to treat uncomplicated urinary tract infections

Kurt G Naber,Florian Wagenlehner,Bela Köves,Zafer Tandogdu,Gernot Bonkat

doi:10.1186/s40816-019-0132-0

Abstract

Urinary tract infections (UTI) are one of the most common problems in urology clinics. The European Association of Urology (EAU) has been pioneering in its efforts to disseminate the latest clinical findings through the organization of the annual EAU congresses. At this year’s congress (EAU Barcelona 2019), various satellite symposia were organized, focusing on specific issues in the field of urology. "UTI − quo vadis? New alternatives to treat uncomplicated urinary tract infections" was one of the industry-sponsored symposia, organized with the aim of evaluating the current scenario and also throwing light on the paradigm shift in the treatment of acute, uncomplicated lower urinary tract infections (uUTI). Several interlinking topics were presented during this symposium. The topics covered antibiotic resistance, involving a presentation of the current data from the Global Prevalence Study on Infections in Urology (GPIU-study). This discussion was followed by case reports on the impact of antibiotic resistance on the management of patients with UTI/uUTI and treatment options for UTI/uUTI according to current guidelines. The highlight of the symposium was the presentation of very recent data from a gold standard phase III clinical trial (double-blind, double-dummy randomized study), demonstrating the non-inferiority of a herbal medicine (BNO 1045) versus antibiotic therapy (fosfomycin trometamol (FT), as a single dose = 3 g) for the treatment of acute, uncomplicated cystitis.

Highlights

Urinary tract infections (UTI) − Quo vadis? New alternatives to treat uncomplicated urinary tract infections Symposium organized at the 34th Annual European Association of Urology (EAU) Congress, Barcelona, Spain, 16th of March 2019.The aim of this symposium was to address the current scenario and to throw light on the paradigm shift in the treatment of acute, uncomplicated lower urinary tract infections
The topics covered antibiotic resistance, involving the current data from the Global Prevalence Study on Infections in Urology (GPIU-study) and case reports on the impact of antibiotic resistance on the management of patients with UTI/uncomplicated lower urinary tract infections (uUTI) and treatment options for UTI/uUTI
Recurrent UTI: 4% diclofenac vs. 3% norfloxacin Recurrent UTI was defined as additional visits after day 14 because of recurrent UTI symptoms after symptoms had resolved by day 10, and the physician decided to treat with antibiotics

Summary

Introduction

UTI − Quo vadis? New alternatives to treat uncomplicated urinary tract infections Symposium organized at the 34th Annual EAU Congress, Barcelona, Spain, 16th of March 2019. Wagenlehner presented four comparative studies showing that initial treatment with a non-steroidal antiinflammatory drug (NSAID) can reduce the use of antibiotics in women with uncomplicated UTI (Table 1) [14,15,16,17]. Wagenlehner reported on the recently published efficacy study which compared the herbal combination BNO 1045 and single-dose fosfomycin (as fosfomycin trometamol = FT) in female patients with acute lower uncomplicated urinary tract infections. The randomized, double-blind, multinational Phase III study in 659 women with acute uncomplicated urinary tract infections (AUC) demonstrated that the phytopharmaceutical BNO 1045 is not inferior to antibiotic therapy with single-shot fosfomycin trometamol (FT) in terms of therapeutic success and reduction of symptoms. Recurrent UTI: 4% diclofenac vs. 3% norfloxacin Recurrent UTI was defined as additional visits after day 14 because of recurrent UTI symptoms after symptoms had resolved by day 10, and the physician decided to treat with antibiotics

Limitations

Conclusion

Findings