USEFUL AGENTS IN THE MANAGEMENT OF URINARY-TRACT INFECTIONS

Urinary tract infections (UTIs) encompass a large variety of clinical conditions ranging from asymptomatic bacteriuria in healthy individual s to life-threatening bacteraemic infections. The choice of antibiotic therapy must be based on identification of the type of UTI to be trea ted, possible contraindicating factors with the individual patient and , above all, knowledge of the antibiotic resistance pattern in the geo graphical area where the patient acquired the bacteriura. In many coun tries trimethoprim-sulphonamide combinations, trimethoprim plain or ni trofurantoin are still useful drugs. Generally, the clinical efficacy of oral beta-lactams such as amoxicillin, ampicillin and cephalosporin s seems to be less good than those of fluoroquinolones and the above-m entioned antibiotics. However, too frequent use of quinolones may lead to increased frequencies of resistance to those antibiotics in common species such as Escherichia coli. It is therefore recommended not to use fluoroquinolones in patients with sporadic uncomplicated cystitis, i.e., the most common type of UTI, but to reserve the modern quinolon es for patients with pyelonephritis, complicated UTI or recurrent UTI.