[Medical therapy of urinary tract infection]

Urinary tract infections (UTI) are the most common bacterial infectious diseases seen in the community, in most cases caused by E. coli. The treatment strategy differs depending on localization (lower vs. upper UT), acute uncomplicated vs. complicated infection, as well as for chronic disease and asymptomatic bacteriuria, the known or susceptible causative uropathogen with the (local) resistance pattern and the morbidity of the patient. There is a considerable worrying increase in the resistance rate of E. coli to TMP/SMX, quinolones and others. Most patients with uncomplicated, in the community acquired UTI are treated safely and effectively as out-patients. The available data support a short-course therapy with 3 days as the current standard therapy for lower UTI, but with a 7-14 days treatment for upper and complicated UTI. Recurrent UTI is best managed by low-dose antimicrobial prophylaxis for 3-6 (12 ore more) months. Besides that, new approaches to preventive strategies must prove their value in specific patient groups.