Urinary anti-infective agent

Scanned electron photograph of E.Coli

Urinary anti-infective agent, also known as urinary antiseptic, is medication that can eliminate microorganisms causing urinary tract infection (UTI). UTI can be categorized into two primary types: cystitis, which refers to lower urinary tract or bladder infection, and pyelonephritis, which indicates upper urinary tract or kidney infection.[1] Escherichia coli (E. Coli) is the predominant microbial trigger of UTIs, accounting for 75% to 95% of reported cases. Other pathogens such as Proteus mirabilis, Klebsiella pneumoniae, and Staphylococcus saprophyticus can also cause UTIs.[2][3]

The use of antimicrobial therapy to treat UTIs started in the 20th century. Nitrofurantoin, trimethoprim-sulfamethoxazole (TMP/SMX), fosfomycin, and pivmecillinam are currently the first-line agents for empiric therapy of simple cystitis.[4] On the other hand, the choice of empiric antimicrobial therapy for pyelonephritis depends on the severity of illness, specific host factors, and the presence of resistant bacteria. Ceftriaxone is often considered for parenteral treatment, while oral or parenteral fluoroquinolones, such as levofloxacin and ciprofloxacin, are suitable alternatives for treating pyelonephritis.[5]

Antimicrobial therapy should be tailored to the individual, considering factors like the severity of illness, specific host factors, and pathogen resistance in the local community.[1]

  1. ^ a b Gupta, Kalpana (2023-12-11). "Acute simple cystitis in adult and adolescent females". UpToDate. Retrieved 2024-03-31.
  2. ^ Czaja, Christopher A.; Scholes, Delia; Hooton, Thomas M.; Stamm, Walter E. (2007-08-01). "Population-based epidemiologic analysis of acute pyelonephritis". Clinical Infectious Diseases. 45 (3): 273–280. doi:10.1086/519268. ISSN 1537-6591. PMID 17599303.
  3. ^ Echols, R. M.; Tosiello, R. L.; Haverstock, D. C.; Tice, A. D. (1999). "Demographic, clinical, and treatment parameters influencing the outcome of acute cystitis". Clinical Infectious Diseases. 29 (1): 113–119. doi:10.1086/520138. ISSN 1058-4838. PMID 10433573.
  4. ^ Gupta, Kalpana; Hooton, Thomas M.; Naber, Kurt G.; Wullt, Björn; Colgan, Richard; Miller, Loren G.; Moran, Gregory J.; Nicolle, Lindsay E.; Raz, Raul; Schaeffer, Anthony J.; Soper, David E.; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases (2011-03-01). "International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases". Clinical Infectious Diseases. 52 (5): e103–120. doi:10.1093/cid/ciq257. ISSN 1537-6591. PMID 21292654.
  5. ^ Gupta, Kalpana (2023-12-11). "Acute complicated urinary tract infection (including pyelonephritis) in adults and adolescents". UpToDate. Retrieved 2024-03-31.