[Lower urinary tract infections in women. Recent data].

J Gynecol Obstet Biol Reprod (Paris)

Département de Gynécologie-Obstétrique, Université de Liège, CHR de la Citadelle, Liège, Belgique.

Published: July 1993

Lower urinary tract infection (LUTI) is a common disease of young women. It usually has a favourable prognosis, but it must not be neglected in view of its frequent recurrences and of the important morbidity it creates leading to social and sexual discomfort. LUTI, therefore, must be diagnosed, and this is done essentially by bacteriological examination of midstream urine. As regards detection of asymptomatic bacteriuria, notably in pregnant or elderly women, the sensitivity of screening is distinctly enhanced by the nitrite and leucocyte esterase tests. Recent publications concerning treatment are in favour of single dose therapy. In uncomplicated urinary tract infections, single doses of antibacterial agents are as effective as the conventional 5 to 7 days administration, and they constitute the treatment of choice of LUTI. In pregnant women, this therapeutic method has the advantage of lesser toxicity and lower frequency of vaginal candidiasis. In patients with frequent recurrences of LUTI, several options are possible: low dose continuous treatment, prophylactic treatment after situations of high risk for reinfection, or self administered single dose as soon as the symptoms reappear. However, the last two methods need to be further evaluated by additional clinical trials.

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