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Latin American consensus on uncomplicated recurrent urinary tract infection—2018

  • Jorge Milhem HaddadEmail author
  • Enrique Ubertazzi
  • Oscar Storme Cabrera
  • Martha Medina
  • Jorge Garcia
  • Silvia Rodriguez-Colorado
  • Efrain Toruno
  • Priscila Katsumi Matsuoka
  • Edgardo Castillo-Pino
Review Article
  • 58 Downloads

Abstract

An estimated 20–30% of adult women who experience an initial urinary tract infection (UTI) will have recurrent infection. In these patients, prophylaxis may be considered to improve their quality of life and control overuse of antibiotics. Despite this need, there is currently no Latin American consensus on the treatment and prophylaxis of recurrent UTIs. This consensus, signed by a panel of regional and international experts on UTI management, aims to address this need and is the first step toward a Latin American consensus on a number of urogynecological conditions. The panel agrees that antibiotics should be considered the primary treatment option for symptomatic UTI, taking into account local pathogen resistance patterns. Regarding prophylaxis, immunoactive therapy with the bacterial lysate OM-89 received a grade A recommendation and local estrogen in postmenopausal women grade B recommendation. Lower-grade recommendations include behavior modification and D-mannose; probiotics (Lactobacilli), cranberries, and hyaluronic acid (and derivatives) received limited recommendations; their use should be discussed with the patient. Though considered effective and receiving grade A recommendation, antimicrobial prophylaxis should be considered only following prophylaxis with effective non-antimicrobial measures that were not successful and chosen based on the frequency of sexual intercourse and local pathogen resistance patterns.

Keywords

Cystitis Recurrent uncomplicated UTI Immunotherapy Prophylaxis Antimicrobial resistance Non-antimicrobial prophylaxis 

Notes

Acknowledgments

The meeting was supported by OM Pharma, a company of Vifor Pharma Group. English language writing and editorial assistance was provided by Daniel Guns of Intelligens Life Ltd.

Funding

The meeting was supported by Vifor Pharma Group. Writing assistance was funded by OM Pharma.

Compliance with ethical standards

Conflicts of interest

JHM has received speaker fees from OM Pharma.

EU has no relevant conflicts of interest to disclose.

OSC has received speaker fees from OM Pharma.

MM has no relevant conflicts of interest to disclose.

JG has no relevant conflicts of interest to disclose.

SRC has no relevant conflicts of interest to disclose.

ET has no relevant conflicts of interest to disclose.

PKM has no relevant conflicts of interest to disclose.

ECP has received speaker fees from OM Pharma.

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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  • Jorge Milhem Haddad
    • 1
    Email author
  • Enrique Ubertazzi
    • 2
  • Oscar Storme Cabrera
    • 3
  • Martha Medina
    • 4
  • Jorge Garcia
    • 5
  • Silvia Rodriguez-Colorado
    • 6
  • Efrain Toruno
    • 7
  • Priscila Katsumi Matsuoka
    • 8
  • Edgardo Castillo-Pino
    • 9
  1. 1.Faculdade de Medicina da Universidade de São PauloItaimBrazil
  2. 2.Hospital Italiano de Buenos AiresBuenos AiresArgentina
  3. 3.Hospital Padre HurtadoUniversidad del DesarrolloSan RamónChile
  4. 4.Hospital Nacional Docente Madre-Niño San BartolomeLimaPeru
  5. 5.Clínica del Country del CountryBogotaColombia
  6. 6.National Institute of PerinatologyMexico CityMexico
  7. 7.Faculdade de MedicinaUNAN León-Universidad Nacional Autónoma de NicaraguaLeónNicaragua
  8. 8.Department of GynecologyUniversidade de São PauloSao PauloBrazil
  9. 9.Hospital de Clínicas “Dr. Manuel Quintela”, Facultad de MedicinaUniversidad de la RepúblicaMontevideoUruguay

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