Treatment of uncomplicated urinary tract infection in non-pregnant women

Abstract

SummaryA study of placebo treatment of acute symptomatic urinary tract infection in non-pregnant women showed that about 80%4 obtained sterile urine spontaneously within 5 months. About one-half of these had recurrent infection within a year.Antimicrobials produced a high immediate cure rate, but only 45°o maintained sterile urine for 2 years. The recurrence rate was highest during the first 2 months after treatment, and thereafter nearly constant during the subsequent 20 months. Twentynine percent of recurrences were recrudescences and 71%4 reinfections. About one-sixth of the patients had a very high recurrence rate, 2-6 infections/year, as compared with 0*32/year in the remainder. Nearly all of these patients had their first recurrence within 5 months of the initial treatment. The probability of recurrence increased with the number of previous infections. Some patients, however, after a period with many recurrences, showed a remarkable decrease in recurrence rate.If the aim of treatment is to keep periods of bacteriuria to a miniimum, it is necessary to do frequent urine cultures for at least 6 months after elimination of bacteriuria. IntroductionThe reasons why some, but not all, apparently healthy women acquire urinary tract infection are still not known, and causal treatment is not possible. In orderto relieve discomfort, prevent septicaemia and, if possible, progressive renal damage in bacteriuric patients, efforts are directed towards sterilization of the urinary tract. Innumerable studies have shown that this can be done by appropriate use of antimicrobial therapy. But it is difficult to evaluate whether treatment significantly alters the course of urinary tract infection in women.In the present study a follow-up was made on non-pregnant women with uncomplicated urinary tract infection, in order to get an impression of the outcome of short-term therapy and the possibilities of reducing periods with bacteriuria.

Binding of uropathogenic Escherichia coli R45 to glycolipids extracted from vaginal epithelial cells is dependent on histo-blood group secretor status.

“…women experience only single or sporadic infections, -20% suffer very frequent (three or more per year) recurrences ( 1). The apparent increased susceptibility to UTI in these patients cannot be explained by underlying functional or anatomic abnormalities of the urinary tract, but instead appears to arise from the interaction of infecting Escherichia coli strains with these patients' epithelial cells.…”

Polymorphisms in the Surfactant Protein A Gene Are Associated with the Susceptibility to Recurrent Urinary Tract Infection in Chinese Women

“…Almost 27% of women developed a recurrent UTI within the 6 months (Foxman 1990) and nearly 50% of women developed a recurrence within the first year following the initial infection (Mabeck 1972). Clinical studies showed that only a fraction of r-UTI patients had obvious functional, anatomic and behavioral risk factors, which were considered to be strongly associated with an increased risk of r-UTI.…”

Population Dynamics and Niche Distribution of Uropathogenic Escherichia coli during Acute and Chronic Urinary Tract Infection

“…When the uropathogen is sensitive to the chosen agent, oral antibiotics typically produce a rapid improvement in symptoms and sterilization of the urine (15, 16). Despite appropriate treatment of a primary UTI, 25 to 40% of adult women will have at least one recurrence (rUTI) within 6 months of her initial infection (33,45). Additionally, up to 20% of women may experience the symptoms of cystitis, or infection of the bladder, with accompanying urine cultures from clean-catch specimens below the diagnostic cutoff of Ͻ10 5 CFU/ml (13).…”