[Choice of antibacterial drugs in urinary infection]

Urologiia. 2012 Mar-Apr:(2):4-8.
[Article in Russian]

Abstract

A rise in efficacy of the treatment of acute infection affecting the lower urinary tract (LUTI) and prolongation of recurrence-free interval in chronic LUTI can be achieved only by an optimal antibacterial treatment. The study was made of 987 community-acquired strains of uropathogens from the patients living in 20 cities of the Russian Federation, Belarus and Kazakhstan (of them, 903 strains were from Russia). Enterobacteriaceae comprised 83.5%. E. coli infection of LUTI was found in 63.5% patients. The incidence of this infection was about the same both in uncomplicated and complicated cases (64.6 and 62.1%, respectively). Most active oral drugs against E.coli were phosphomycin (98.4%), furasidin (95.7%), nitrofurantoin (94.1%) and oralcefalosporins of the third generation (ceftibuten and cefixim). As to Enterobacteriaceae, only phosphomycin had activity against these bacteria above 90%, i.e. 91.5%. Furasidin and nitrofurantoin activity was 86.3 and 76.8%, respectively. From parenteral drugs, most active against E. coli were carbapenems (ertapenem, meropenem, imipenem. Strains resistant to them were not isolated. High in vitro activity was demonstrated also by cefoperason/sulbactam (97.4%), piperacillin/tasobactam (95.7%), cefalosporins of the third/fourth generation and amikacin (98.9%). Carbapenems were also highly active against Enterobacteroaceae. Empiric treatment of uncomplicated urinary infection should be performed with medicines which are not used for other indications.

Publication types

  • English Abstract
  • Multicenter Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Drug Resistance, Bacterial / drug effects
  • Enterobacteriaceae / growth & development
  • Enterobacteriaceae / isolation & purification*
  • Enterobacteriaceae Infections / drug therapy*
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / microbiology*
  • Female
  • Humans
  • Kazakhstan / epidemiology
  • Male
  • Republic of Belarus / epidemiology
  • Russia / epidemiology
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology*

Substances

  • Anti-Bacterial Agents