Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women
Urinary tract infection (UTI) is a common condition in women. There is an increased concern on reduction of bacterial susceptibility resulting from wrongly prescribing antimicrobials. This paper summarizes the recommendations of four Brazilian medical societies (SBI – Brazilian Society of Infectious...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-03-01
|
| Series: | Brazilian Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867020300283 |
| _version_ | 1819117872618668032 |
|---|---|
| author | Patricia de Rossi Sergio Cimerman José Carlos Truzzi Clóvis Arns da Cunha Rosiane Mattar Marinês Dalla Valle Martino Maurício Hachul Adagmar Andriolo José Ananias Vasconcelos Neto João Antônio Pereira-Correia Antonia M.O. Machado Ana Cristina Gales |
| author_facet | Patricia de Rossi Sergio Cimerman José Carlos Truzzi Clóvis Arns da Cunha Rosiane Mattar Marinês Dalla Valle Martino Maurício Hachul Adagmar Andriolo José Ananias Vasconcelos Neto João Antônio Pereira-Correia Antonia M.O. Machado Ana Cristina Gales |
| author_sort | Patricia de Rossi |
| collection | DOAJ |
| description | Urinary tract infection (UTI) is a common condition in women. There is an increased concern on reduction of bacterial susceptibility resulting from wrongly prescribing antimicrobials. This paper summarizes the recommendations of four Brazilian medical societies (SBI – Brazilian Society of Infectious Diseases, FEBRASGO – Brazilian Federation of Gynecology and Obstetrics Associations, SBU – Brazilian Society of Urology, and SBPC/ML – Brazilian Society of Clinical Pathology/Laboratory Medicine) on the management of urinary tract infection in women.Asymptomatic bacteriuria should be screened at least twice during pregnancy (early and in the 3rd trimester). All cases of significant bacteriuria (≥105 CFU/mL in middle stream sample) should be treated with antimicrobials considering safety and susceptibility profile. In women with typical symptoms of cystitis, dipsticks are not necessary for diagnosis. Urine cultures should be collected in pregnant women, recurrent UTI, atypical cases, and if there is suspicion of pyelonephritis. First line antimicrobials for cystitis are fosfomycin trometamol in a single dose and nitrofurantoin, 100 mg every 6 hours for five days. Second line drugs are cefuroxime or amoxicillin-clavulanate for seven days. During pregnancy, amoxicillin and other cephalosporins may be used, but with a higher chance of therapeutic failure.In recurrent UTI, all episodes should be confirmed by urine culture. Treatment should be initiated only after urine sampling and with the same regimens indicated for isolated episodes. Prophylaxis options of recurrent UTI are behavioral measures, non-antimicrobial and antimicrobial prophylaxis. Vaginal estrogens may be recommended for postmenopausal women. Other non-antimicrobial prophylaxis, including cranberry and immunoprophylaxis, have weak evidence supporting their use. Antimicrobial prophylaxis may be offered as a continuous or postcoital scheme. In pregnant women, options are cephalexin, 250–500 mg and nitrofurantoin, 100 mg (contraindicated after 37 weeks of pregnancy). Nonpregnant women may use fosfomycin trometamol, 3 g every 10 days, or nitrofurantoin, 100 mg (continuous or postcoital). |
| first_indexed | 2024-12-22T05:39:53Z |
| format | Article |
| id | doaj.art-af4dd3549089483faecec18ce0ef0edc |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-22T05:39:53Z |
| publishDate | 2020-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-af4dd3549089483faecec18ce0ef0edc2022-12-21T18:37:13ZengElsevierBrazilian Journal of Infectious Diseases1413-86702020-03-01242110119Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant womenPatricia de Rossi0Sergio Cimerman1José Carlos Truzzi2Clóvis Arns da Cunha3Rosiane Mattar4Marinês Dalla Valle Martino5Maurício Hachul6Adagmar Andriolo7José Ananias Vasconcelos Neto8João Antônio Pereira-Correia9Antonia M.O. Machado10Ana Cristina Gales11Conjunto Hospitalar do Mandaqui and Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO), São Paulo, SP, Brazil; Corresponding author.Instituto de Infectologia Emílio Ribas, São Paulo, SP, BrazilUniversidade Federal de São Paulo (UNIFESP) and Instituto do Câncer Arnaldo Vieira de Carvalho (IAVC), São Paulo, SP, BrazilUniversidade Federal do Paraná (UFPR), Curitiba, PR, BrazilUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Obstetrícia, São Paulo, SP, BrazilFaculdade de Ciências Médicas da Santa Casa de São Paulo and Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, BrazilSociedade Brasileira de Urologia (SBU), São Paulo, SP, BrazilUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), São Paulo, SP, BrazilUniversidade Federal do Ceará (UFC), Ceará, CE, BrazilServiço de Urologia do Hospital dos Servidores do Estado do Rio de Janeiro and Departamento de Urologia Feminina da Sociedade Brasileira de Urologia (SBU), Rio de Janeiro, RJ, BrazilUniversidade Federal de São Paulo (UNIFESP), Hospital São Paulo, Escola Paulista de Medicina (EPM), São Paulo, SP, BrazilUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Medicina, São Paulo, SP, BrazilUrinary tract infection (UTI) is a common condition in women. There is an increased concern on reduction of bacterial susceptibility resulting from wrongly prescribing antimicrobials. This paper summarizes the recommendations of four Brazilian medical societies (SBI – Brazilian Society of Infectious Diseases, FEBRASGO – Brazilian Federation of Gynecology and Obstetrics Associations, SBU – Brazilian Society of Urology, and SBPC/ML – Brazilian Society of Clinical Pathology/Laboratory Medicine) on the management of urinary tract infection in women.Asymptomatic bacteriuria should be screened at least twice during pregnancy (early and in the 3rd trimester). All cases of significant bacteriuria (≥105 CFU/mL in middle stream sample) should be treated with antimicrobials considering safety and susceptibility profile. In women with typical symptoms of cystitis, dipsticks are not necessary for diagnosis. Urine cultures should be collected in pregnant women, recurrent UTI, atypical cases, and if there is suspicion of pyelonephritis. First line antimicrobials for cystitis are fosfomycin trometamol in a single dose and nitrofurantoin, 100 mg every 6 hours for five days. Second line drugs are cefuroxime or amoxicillin-clavulanate for seven days. During pregnancy, amoxicillin and other cephalosporins may be used, but with a higher chance of therapeutic failure.In recurrent UTI, all episodes should be confirmed by urine culture. Treatment should be initiated only after urine sampling and with the same regimens indicated for isolated episodes. Prophylaxis options of recurrent UTI are behavioral measures, non-antimicrobial and antimicrobial prophylaxis. Vaginal estrogens may be recommended for postmenopausal women. Other non-antimicrobial prophylaxis, including cranberry and immunoprophylaxis, have weak evidence supporting their use. Antimicrobial prophylaxis may be offered as a continuous or postcoital scheme. In pregnant women, options are cephalexin, 250–500 mg and nitrofurantoin, 100 mg (contraindicated after 37 weeks of pregnancy). Nonpregnant women may use fosfomycin trometamol, 3 g every 10 days, or nitrofurantoin, 100 mg (continuous or postcoital).http://www.sciencedirect.com/science/article/pii/S1413867020300283Urinary tract infectionWomenPregnancyAsymptomatic bacteriuriaCystitisRecurrent |
| spellingShingle | Patricia de Rossi Sergio Cimerman José Carlos Truzzi Clóvis Arns da Cunha Rosiane Mattar Marinês Dalla Valle Martino Maurício Hachul Adagmar Andriolo José Ananias Vasconcelos Neto João Antônio Pereira-Correia Antonia M.O. Machado Ana Cristina Gales Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women Brazilian Journal of Infectious Diseases Urinary tract infection Women Pregnancy Asymptomatic bacteriuria Cystitis Recurrent |
| title | Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women |
| title_full | Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women |
| title_fullStr | Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women |
| title_full_unstemmed | Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women |
| title_short | Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women |
| title_sort | joint report of sbi brazilian society of infectious diseases febrasgo brazilian federation of gynecology and obstetrics associations sbu brazilian society of urology and sbpc ml brazilian society of clinical pathology laboratory medicine recommendations for the clinical management of lower urinary tract infections in pregnant and non pregnant women |
| topic | Urinary tract infection Women Pregnancy Asymptomatic bacteriuria Cystitis Recurrent |
| url | http://www.sciencedirect.com/science/article/pii/S1413867020300283 |
| work_keys_str_mv | AT patriciaderossi jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT sergiocimerman jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT josecarlostruzzi jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT clovisarnsdacunha jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT rosianemattar jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT marinesdallavallemartino jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT mauriciohachul jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT adagmarandriolo jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT joseananiasvasconcelosneto jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT joaoantoniopereiracorreia jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT antoniamomachado jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri AT anacristinagales jointreportofsbibraziliansocietyofinfectiousdiseasesfebrasgobrazilianfederationofgynecologyandobstetricsassociationssbubraziliansocietyofurologyandsbpcmlbraziliansocietyofclinicalpathologylaboratorymedicinerecommendationsfortheclinicalmanagementofloweruri |