Subject: Inquiry about a guideline for treatment of bacterial cystitis
Dear Sirs,
I am an assistant professor of urology department in Gifu University, Japan.
And I am interested in urinary tract infection, especially, in acute bacterial cystitis.
I want ask you some questions.
My questions are:
Is there a nationwide guideline or consensus for the antimicrobial treatment
of acute bacterial cystitis in your country? If so, please inform me detail.
Is there a problem of antibiotic resistance in the isolates from acute bacterial
cystitis in your country?
Thank you. Your cooperation is greatly appreciated.
Satoshi Ishihara
Assistant Professor
Department of Urology
Gifu University, Graduate School of Medicine
Сотрудник НИИАХ Posts: 13
Dear Dr. Ishihara,
At present in Russia there are 3 different guidelines on antibiotic therapy of urinary tract infections (UTI):
1) Antimicrobial therapy of uncomplicated UTI in adult patients;
2) Antimicrobial therapy of uncomplicated UTI in pregnant women;
3) Antimicrobial therapy of uncomplicated UTI in children.
They were developed by Institute of Antimicrobial Chemotherapy (Smolensk, Russia), Institute of Urology (Moscow), Scientific Centre for Obstetrics and Gynecology (Moscow), Institute of Pediatrics (Moscow) and many others. These guidelines are based on the results multi-centre microbiological surveys evaluated antimicrobial resistance in UTI pathogens.
According to obtained data the main problem is a high level of resistance to co-trimoxazole (15-30%) and to aminopenicillins (30-50%).
Additional information you could find in sources indicated below.
Resistance of E.coli isolates from pregnant and non-pregnant women with community-acquired urinary tract Infections in Russia: results of multi-center studies UTIAP-2002 and ARIMB
http://www.antibiotic.ru/files/pdf/en/eccmid-prague04.pdf
Resistance of E.coli isolated from children with community-acquired urinary tract infections (CAUTIs) in Russia: Results of multicenter study «ARMID»
http://www.antibiotic.ru/en/ar/pub/g1469.shtml
--
Vladimir Rafalski, MD, PhD
Deputy Director
Institute of Antimicrobial Chemotherapy (IAC)
Smolensk State Medical Academy
214019, Russian Federation, Smolensk,
28 Krupskaya Street, P.O. Box 5
Phones: + 7-0812-611301 or + 7-0812-611327
Fax: + 7-0812-611294
Dear Dr. Rafalski,
Thank you for your reply.
I want to ask you again,
What are the recommended or first-line antibiotics for uncomplicated UTI according to the guideline (1) for adult patients? Are they co-trimoxazole or aminopenicillins?
What are the actually common antibiotics for uncomplicated UTI of adult patients in Russia?
Best regards, Satoshi Ishihara
********************************
Satoshi Ishihara
Assistant Professor
Department of Urology
Gifu University, Graduate School of Medicine
1-1 Yanagido, Gifu, 501-1194
Japan
Редактор сайта Posts: 113
Dear Dr. Ishihara,
No. Due to high level of resistance of main UT pathogens ampicillin and co-trimoxazole could not be considered as the first-line antibiotics. First-line antibiotics for uncomplicated UTI in adults in Russia are fluoroquinolones (ciprofloxacin, norfloxacin, etc.), amoxicillin/clavulanic acid and fosfomycin (acute cystitis) and fluoroquinolones, amoxicillin/clavulanic acid and cephalosporins II-III for acute pyelonephritis.
If you mean the most commonly prescribed medications for UTI, then ampicillin, fluoroquinolones, nitrofurantoin, co-trimoxazole were the most frequently used antibiotics in out-patient practice.
The detailed answer on the second question you can find here:
