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Short-term treatment of urinary tract infections: the french concept

Kurzzeit-Therapie bei Harnwegsinfektionen. Das französische Konzept

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Summary

The indications for short-term treatment to cure urinary tract infections (UTIs) have been recently clarified in France by a “Consensus Conference”. Short-term treatment essentially concerns young, non-pregnant women with symptomatic uncomplicated lower UTI of less than three days duration, with no other underlying severe illness or previous uro-nephrological history, and who accept the idea of clinical and possibly bacteriological control after treatment. Only antibiotics with prolonged urinary excretion are recommended, i.e. co-trimoxazole, fluoroquinolones or fosfomycin-trometamol. In pregnancy, in children, or in the elderly, indications for short-term treatment still remain controversial. As compared with conventional therapeutic strategies using urine cultures, the use of test strips for nitrite and leukocyte esterase for deciding on treatment and assessing its efficacy should allow considerable financial savings.

Zusammenfassung

In Frankreich fand kürzlich eine Konsensus- Konferenz zur Einigung über die Indikationen für eine Kurzzeit-Therapie zur Behandlung von Harnwegsinfektionen statt. Eine Kurzzeit-Therapie kommt grundsätzlich für nicht schwangere, junge Frauen mit symptomatischer unkomplizierter Harnwegsinfektion in Frage. Die Erkrankung sollte weniger als drei Tage bestehen. Andere schwere Grundkrankheiten oder eine urologisch-nephrologische Vorgeschichte sind auszuschließen. Die Frauen sollten sich außerdem einverstanden erklären, daß eine klinische und möglicherweise auch eine bakteriologische Kontrolluntersuchung nach Therapieende durchgeführt wird. Nur Antibiotika mit prolongierter Harnausscheidung können empfohlen werden, wie Co-trimoxazol, fluorierte Chinolone und Fosfomycin Trometamol. Die Indikationen für eine Kurzzeittherapie bei Schwangeren, Kindern und bei älteren Patienten sind noch ungeklärt. Im Vergleich zu konventionellen Strategien, bei denen Urinkulturen angelegt werden, sollten durch Anwendung von Teststreifen für den Nachweis von Nitrit und Leukozytenesterase zur Entscheidung über Therapiebedürftigkeit und Therapieerfolg erhebliche Kosteneinsparungen möglich sein.

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  1. Maladies Infectieuses et Tropicales, Hôpital Universitaire Charles Nicolle, F-76031, Rouen Cedex, France

    F. Caron M. D. &  G. Humbert M. D.

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  1. F. Caron M. D.
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  2. G. Humbert M. D.
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Caron, F., Humbert, G. Short-term treatment of urinary tract infections: the french concept. Infection 20 (Suppl 4), S286–S290 (1992). https://doi.org/10.1007/BF01710016

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