Effective Prophylaxis for Recurrent Urinary Tract Infections during Pregnancy

Pfau, Alphonse; Sacks, T.

doi:10.1093/clinids/14.4.810

Cited by 86 publications

(30 citation statements)

References 16 publications

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“…82,83 They should subsequently be treated with antibiotics such as nitrofurantoin, sulfisoxazole or cephalexin. 21,24,[82][83][84] Antibiotic prophylaxis for RUTI in pregnant women is effective using continuous or post-coital regimens. The causative organisms of UTI in pregnancy are similar to those found in non-pregnant patients, with E. coli accounting for 80-90% of infections.…”

Section: Other Therapiesmentioning

confidence: 99%

Recurrent Urinary Tract Infections Management in Women : A Review = الإلتهابات المتكررة للمسالك البولية عند النساء و طرق علاجها : مراجعة

Al‐Badr

Al‐Shaikh

2013

SQUMJ

187

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U rinary tract infections (UTIs) occur more often in women than in men, at a ratio of 8:1. Approximately 50-60% of women report at least one UTI in their lifetime, and one in three will have at least one symptomatic UTI necessitating antibiotic treatment by age 24. [1][2][3] Normally, the urinary tract is sterile, but bacteria may rise from the perianal region, possibly leading to UTI. Pathogens in the bladder may stay silent or can cause irritative symptoms like urinary frequency and urgency, and 8% of women may have asymptomatic bacteriuria. If bacteria enter the blood stream, they could cause severe complications, including septicaemia, shock and, rarely, death. 4,5 The definition of recurrent urinary tract infection (RUTI) is three UTIs with three positive urine cultures during a 12-month period, or two infections during the previous 6 months. [5][6][7][8] This article provides an up-to-date review of the epidemiology, pathophysiology, risk factors, diagnosis, management and prevention of RUTIs in women. Classification of Urinary Tract InfectionsUTIs are classified into 6 categories. The first category is an uncomplicated infection; this is when the urinary tract is normal, both structurally and physiologically, and there is no associated disorder that impairs the host defense mechanisms. The second category is an complicated infection; this is Escherichia coli is the organism that causes UTIs in most patients. Recurrent UTIs (RUTI) are mainly caused by reinfection by the same pathogen. Having frequent sexual intercourse is one of the greatest risk factors for RUTIs. In a subgroup of individuals with coexisting morbid conditions, complicated RUTIs can lead to upper tract infections or urosepsis. Although the initial treatment is antimicrobial therapy, use of different prophylactic regimens and alternative strategies are available to reduce exposure to antibiotics.

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Section: Other Therapiesmentioning

confidence: 99%

Recurrent Urinary Tract Infections Management in Women : A Review = الإلتهابات المتكررة للمسالك البولية عند النساء و طرق علاجها : مراجعة

Al‐Badr

Al‐Shaikh

2013

SQUMJ

187

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“…After a negative culture is obtained, daily antimicrobial suppression should be considered, which may consist of 50 to 100 mg of nitrofurantoin orally nightly [1,40]. Without prophylaxis, as many as one third of women will experience recurrent infections during pregnancy [2,32].…”

Section: Preventionmentioning

confidence: 99%

Asymptomatic Bacteriuria and Symptomatic Urinary Tract Infections During Pregnancy

Macejko

Schaeffer

2007

Urologic Clinics of North America

115

102

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“…Surprisingly, although observation is that pregnant women have a tendency to recurrent UTIs during gestation, there is very little knowledge as to whether this phenomenon is similar to that of healthy, nonpregnant women [44,45].…”

Section: Recurrent Infectionsmentioning

confidence: 99%

Urinary tract infection in pregnant women: Old dogmas and current concepts regarding pathogenesis

Nowicki

2002

Curr Infect Dis Rep

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The dogma is that the higher risk of pyelonephritis in pregnant women is explained entirely by anatomic/obstructive changes. If so, gestational pyelonephritis should be caused by random, nonpathogenic bacteria. Instead, gestational pyelonephritis is associated with a narrow group of genetically related Escherichia coli and virulence factors, implicating a more complex pathophysiology. Current concepts in the pathogenesis of nongestational urinary tract infections propose receptor-mediated ascending infection. A pathogen with capacity to recognize various receptors may use receptors in the lower, rather than upper urinary tract, and ascend even the lumen of renal tubules. The immune system of a pregnant mother is modified to accommodate a semiallogeneic fetus. Gestational physiologic/immune adaptations may become additional risk factors, increasing sensitivity to urogenital infection. One could argue that it is not primarily the so-called "obstruction," but rather specific changes in the immune system and host receptors that act in concert with--or become exploited by--bacterial virulence that allow for infection in pregnancy to occur.

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Effective Prophylaxis for Recurrent Urinary Tract Infections during Pregnancy

Cited by 86 publications

References 16 publications

Recurrent Urinary Tract Infections Management in Women : A Review = الإلتهابات المتكررة للمسالك البولية عند النساء و طرق علاجها : مراجعة

Recurrent Urinary Tract Infections Management in Women : A Review = الإلتهابات المتكررة للمسالك البولية عند النساء و طرق علاجها : مراجعة

Asymptomatic Bacteriuria and Symptomatic Urinary Tract Infections During Pregnancy

Urinary tract infection in pregnant women: Old dogmas and current concepts regarding pathogenesis

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