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Int Urogynecol J. 2019 Sep 7. doi: 10.1007/s00192-019-04079-5. [Epub ahead of print]

Latin American consensus on uncomplicated recurrent urinary tract infection-2018.

Author information

1
Faculdade de Medicina da Universidade de São Paulo, Rua Dr Renato Paes de Barros 901 ap 72, Itaim, São Paulo, 04530000, Brazil. Jorge_milhem@uol.com.br.
2
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
3
Hospital Padre Hurtado, Universidad del Desarrollo, San Ramón, Chile.
4
Hospital Nacional Docente Madre-Niño San Bartolome, Lima, Peru.
5
Clínica del Country del Country, Bogota, Colombia.
6
National Institute of Perinatology, Mexico City, Mexico.
7
Faculdade de Medicina, UNAN León-Universidad Nacional Autónoma de Nicaragua, León, Nicaragua.
8
Department of Gynecology, Universidade de São Paulo, Sao Paulo, Brazil.
9
Hospital de Clínicas "Dr. Manuel Quintela", Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.

Abstract

An estimated 20-30% of adult women who experience an initial urinary tract infection (UTI) will have recurrent infection. In these patients, prophylaxis may be considered to improve their quality of life and control overuse of antibiotics. Despite this need, there is currently no Latin American consensus on the treatment and prophylaxis of recurrent UTIs. This consensus, signed by a panel of regional and international experts on UTI management, aims to address this need and is the first step toward a Latin American consensus on a number of urogynecological conditions. The panel agrees that antibiotics should be considered the primary treatment option for symptomatic UTI, taking into account local pathogen resistance patterns. Regarding prophylaxis, immunoactive therapy with the bacterial lysate OM-89 received a grade A recommendation and local estrogen in postmenopausal women grade B recommendation. Lower-grade recommendations include behavior modification and D-mannose; probiotics (Lactobacilli), cranberries, and hyaluronic acid (and derivatives) received limited recommendations; their use should be discussed with the patient. Though considered effective and receiving grade A recommendation, antimicrobial prophylaxis should be considered only following prophylaxis with effective non-antimicrobial measures that were not successful and chosen based on the frequency of sexual intercourse and local pathogen resistance patterns.

KEYWORDS:

Antimicrobial resistance; Cystitis; Immunotherapy; Non-antimicrobial prophylaxis; Prophylaxis; Recurrent uncomplicated UTI

PMID:
31494690
DOI:
10.1007/s00192-019-04079-5

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