[Lower urinary tract infections: bacterial epidemiology and recommendations]

Lower urinary tract infection remains frequent particularly in women, despite improvement in therapeutic means. It seems likely to revisit bacterial epidemiology and therapeutic available strategies. To analyze elements in presence i.e. infecting bacteria and antibiotics still active or identification of acquired resistance mechanisms should permit to establish the evolution during the last 10 years. The study shows that bacterial epidemiology in urinary tract infection has not changed significantly, despite antibiotic selective pressure expected from overused antibiotics. However few enterobacteriaceae more resistant than Escherichia coli have emerged, but the latter remains predominant. Development of resistance has concerned Negram, amoxicillin and Augmentin, but several active molecules such as ciprofloxacin, Monuril remain available. Duration of treatments are still discussed but there is a tend toward short durations and even mono-doses. The control of lower urinary tract infections remains relatively easy provided that a good therapeutic choice is based on well documented bacteriologic data (infecting species susceptible to the available antibiotics).