Advances in Antimicrobial Therapy of Urinary Tract Infection
Keywords:Urinary tract infection, pathogenesis, therapy, quinolones
Urinary tract infections (UTI) are one of the most common infections that a clinician is called upon to treat, both in the community and the hospital setting. The prevalence, as well as the spectrum, of etiologic pathogens differs in women and men; for example, E. coli is the causative pathogen in 80% to 95% of cases in women, whereas it does so in less than 50% of cases in men, in whom other Enterobacteriaceae and Gram-positive organisms are more commonly found.
Various studies have improved our understanding of the pathogenesis of UTI which, in turn, has led to a more rational use of the wide variety of antimicrobials now available. The drugs which achieve high intramedullary levels correlate better with the cure in upper tract UTIs. Agents like trimethoprim-sulfamethoxazole and fluoroquinolones eradicate aerobic Gram-negative rods from the fecal and vaginal flora and provide long-term cure. Short-course therapy has now become the standard for most female patients with cystitis, but a 7-14 day therapy is required in other situations.
Presented at the IMA 24th Annual Convention, Long Island, New York, July 1991
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