Infektološki glasnik, Vol. 34 No. 4, 2014.
Stručni rad
Amendments and updates to the ISKRACroatian national guidelines for the treatment and prophylaxis of urinary tract infections in adults
Višnja Škerk
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Arjana Tambić Andrašević
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Edita Sušić
; Zavod za javno zdravstvo šibensko-kninske županije, Šibenik, Hrvatska
Sažetak
When selecting appropriate antimicrobial treatment for urinary tract infections (UTIs), the following drug characteristics should be taken into account: spectrum of activity, in vitro efficacy, pharmacokinetics, pharmacodynamics, side effects, drug interactions, contraindications, the location of treatment, cost, ease of administration, individual characteristics of particular patient and infection, the position of the drug on the Croatian Health Insurance Fund medicine list. In determining the empirical antimicrobial therapy for UTIs, one has to consider the results of local research on causative pathogens for particular clinical syndromes and their susceptibility to antimicrobial agents. According to ISKRA Croatian National Guidelines and their amendments and updates, with regards to EUCAST recommendations for UTI treatmet, the following is recommended:
– for acute uncomplicated lower UTIs in women, the drug of choice is nitrofurantoin (2×100 mg po. for 7 days), or fosfomycin (1×3.0 g po. once), and as alternative therapy co-amoxiclav (2×1.0 g po. for 7 days), cephalexin (2×1.0 g po. for 7 days), cefuroxime axetil or cefixime or, followed by norfloxacin (2×400 mg. po. for 3 days);
– for acute uncomplicated pyelonephritis the drug of choice is coamoxiclav (2×1.0 g po. for 10–14 days), and as alternative therapy the 2nd or 3rd generation cephalosporins for 10–14 days, and ciprofloxacin (2×500 mg po. for 7–10 days),
– for complicated UTIs in women the drug of choice is coamoxiclav (2×1.0 g po. for 10–14 days) and the alternative therapy is ceftibuten, that is ciprofloxacin (2×500 mg po. for 7–10 days);
– for acute UTIs in men who have systemic symptoms, the drug of choice is ciprofloxacin (2×500 mg po. for 2 weeks), and alternative therapy is co-amoxiclav (2×1.0 g po. for 14 days) or ceftriaxone for 14 days;
– for UTIs in men with complaints that correspond to chronic bacterial prostatitis the drug of choice is ciprofloxacin (2×500 mg po. for 4 weeks), and alternative therapies are trimethoprim / sulfamethoxazole or ceftibuten;
– for UTIs in pregnant women, according to clinical syndromes, duration of pregnancy and antibiogram of the causative pathogen, the following 7–14 day therapy is recommended: ceftibuten,
co-amoxiclav, nitrofurantoin, amoxicillin or fosfomycin.
Ključne riječi
Urinary tract infections; guidelines; adults; treatment; prophylaxis
Hrčak ID:
143356
URI
Datum izdavanja:
30.12.2014.
Posjeta: 3.735 *