Review article
Complicated urinary tract infections and the choice of antibiotics
Ljiljana Betica-Radić
; Infektološki odjel, Opća bolnica Dubrovnik, Dubrovnik, Hrvatska
Abstract
Complicated urinary tract infections (UTI) are a heterogenous group of diseases which present a therapeutic problem because of the need for multidisciplinary approach and because of unpredicted antibiotic susceptibility due to the emergence of antibiotic resistance among isolated pathogens. According to the guidelines for antimicrobial treatment and prophylaxis of urinary tract infections developed by the Interdisciplinary Section for Antibiotic Resistance Control (ISKRA) of the Croatian Ministry of Health and Social Welfare, in accordance with the IDSA (Infectious Diseases Society of America) and ESCMID (European Society of Clinical Microbiology and Infectious Diseases), complicated urinary tract diseases are classified as: UTI of adult men, complicated UTI in the presence of functional or anatomic abnormalities of the urotract, nosocomial UTI and UTI in the presence of indwelling foreign bodies (catheters), UTI in pregnant women and UTI in women in postmenopause. The selected drug should have appropriate spectrum of activity against a specific or probable pathogen and good penetration properties. Differences in pharmacokinetics and pharmacodynamics and their relations, have an influence on optimal antibiotic dosage regimen. Defined pharmacokinetic and pharmacodynamic factors (PK/PD) such as Cmax/MIC, AUC and T>MIC, are excellent predictors of microbiological and clinical efficacy. Treatment failure is often the result of insufficient knowledge of pharmacokinetic and pharmacodynamic properties of antibiotics.
Keywords
Complicated urinary tract infections; pharmacokinetics; pharmacodynamics; antibiotics
Hrčak ID:
59801
URI
Publication date:
30.6.2010.
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