Urinary tract infections in therapist’s practice


DOI: https://dx.doi.org/10.18565/therapy.2023.3.52-60

Sigitova O.N., Bogdanova A.R., Khasanova M.I., Kim T. Yu., Batyushin M.M.

1) Kazan State Medical University of the Ministry of Healthcare of Russia; 2) Kazan (Volga Region) Federal University; 3) Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia; 4) Rostov State Medical University of the Ministry of Healthcare of Russia, Rostov-on-Don
Abstract. Strategy and tactics of antimicrobial therapy for urinary tract infections (UTIs) have undergone significant changes in the last 10 years due to the global increase of infectious agents’ resistance to antibiotics. In the last decade, opinions on many seemingly unshakable truths in this area have changed. Now is accepted that urine is not sterile, but contains many microbes that make up the microbiome, while asymptomatic bacteriuria (ASB) is not considered to be a disease and in most cases is not treated. The UTI therapy strategy has changed: if in acute forms of this infection (cystitis, pyelonephritis) the aim is clinical and microbiological recovery, then in recurrent and chronic UTIs, therapy is aimed at reducing the frequency of relapses and lengthening the interrecurrent period, and it is allowed to achieve clinical recovery without microbiological, i.e. with the preservation of ASB. Rational choice of empiric antimicrobial therapy plays the main role in solving these problems. In addition, the strategy for the prevention and treatment of continuously recurrent UTIs has changed: previously used long-term courses of therapy with subtherapeutic doses of antimicrobials are currently not recommended due to the high risk of resistant microflora formation.
Keywords: antimicrobial therapy, cystitis, asymptomatic bacteriuria, pyelonephritis, urinary tract infections
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About the Autors

Olga N. Sigitova, MD, professor of the Department of polyclinic therapy and general medical practice, Kazan State Medical University of the Ministry of Healthcare of Russia, professor of the Department of urology of Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova Str. E-mail: osigit@rambler.ru. ORCID: https://orcid.org/0000-0001-8983-245X
Alina R. Bogdanova, PhD in Medical Sciences, associate professor of the Department of internal medicine, Kazan (Volga Region) Federal University. Address: 420008, Kazan, 18 Kremlyovskaya Str. E-mail: _alinochka@mail.ru. ORCID: https://orcid.org/0000-0001-6953-464X
Milyausha I. Khasanova, PhD in Medical Sciences, associate professor of the Department of urology and nephrology, Kazan State Medical Academy – a branch of Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 36 Butlerova Str. E-mail: milyash@inbox.ru. ORCID: https://orcid.org/0000-0002-9164-0614
Taisiya Yu. Kim, PhD in Medical Sciences, associate professor of the Department of polyclinic therapy and general medical practice, Kazan State Medical University of the Ministry of Healthcare of Russia. Address: 420012, Kazan, 49 Butlerova Str. E-mail: tais_ariana@mail.ru. ORCID: https://orcid.org/0000-0003-2370-2972
Mikhail M. Batyushin, MD, professor of the Department of internal medicine No. 2, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344000, Rostov-on-Don, 29 Nakhichevansky pereulok Str. E-mail: batjushin-m@rambler.ru. ORCID: https://orcid.org/0000-0002-5329-7050


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