Guideline of guidelines: management of recurrent urinary tract infections in women.

Autor:	Kwok M; Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia.; Department of Urology, Redcliffe Hospital, Redcliffe, Qld, Australia., McGeorge S; Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia., Mayer-Coverdale J; Herston ID Institute (HEIDI), Brisbane, Qld, Australia., Graves B; Herston ID Institute (HEIDI), Brisbane, Qld, Australia., Paterson DL; Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.; Faculty of Medicine, University of Queensland Centre for Clinical Research, Brisbane, Qld, Australia., Harris PNA; Faculty of Medicine, University of Queensland Centre for Clinical Research, Brisbane, Qld, Australia.; Central Laboratory, Pathology Queensland, Brisbane, Qld, Australia., Esler R; Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia., Dowling C; Department of Urology, Eastern Health, Melbourne, Vic., Australia., Britton S; Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.; Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Herston, Qld, Australia., Roberts MJ; Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.; Department of Urology, Redcliffe Hospital, Redcliffe, Qld, Australia.; Faculty of Medicine, University of Queensland Centre for Clinical Research, Brisbane, Qld, Australia.
Jazyk:	angličtina
Zdroj:	BJU international [BJU Int] 2022 Nov; Vol. 130 Suppl 3, pp. 11-22. Date of Electronic Publication: 2022 May 17.
DOI:	10.1111/bju.15756
Abstrakt:	Objective: To compare recurrent urinary tract infection (rUTI) guidelines from major urological and non-urological organisations internationally and identify areas of consensus and discrepancy. Methods: PubMed, Google Scholar and the official webpages of major urological, gynaecological, infectious diseases and general practice organisations were searched for rUTI guidelines in March 2022. Nine guidelines were included for review: European Association of Urology, National Institute for Health and Care Excellence (NICE), Society of Obstetricians and Gynaecologists of Canada, American Academy of Family Physicians, Mexican College of Gynaecology and Obstetrics Specialists, Swiss Society of Gynaecology and Obstetrics, Spanish Society of Infectious Diseases and Clinical Microbiology, German Association of Scientific Medical Societies, and the combined American Urological Association/Canadian Urological Association/Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction. Results: The definition and evaluation of rUTIs, and antibiotic prophylaxis strategies, were mostly consistent across guidelines, and emphasised the importance of obtaining urine cultures and limiting cystoscopy and upper tract imaging in women without risk factors. Variable recommendations were noted for symptomatic treatment, self-initiated antibiotics, and antibiotic-sparing preventative strategies such as cranberry, vaginal oestrogen, immunoactive prophylaxis with OM-89, intravesical glycosaminoglycan instillation, and phytotherapeutics. Recent randomised evidence supports the use of methenamine hippurate. Either continuous or post-coital prophylactic antibiotics were supported by all guidelines. None of the guidelines were tailored to the management recurrent complicated UTI. Conclusion: Multiple rUTI guidelines were identified and mostly limited their recommendations to otherwise healthy non-pregnant women with uncomplicated cystitis. Variation was noted, particularly in antibiotic-sparing preventative strategies. Some conflicting recommendations are due to more recent guidelines including updated evidence. Future guidelines should consider recommendations to assist management of complex patient groups, such as recurrent complicated UTI. (© 2022 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.)
Databáze:	MEDLINE
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