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Principles of Bacterial Urinary Tract Infections and Antimicrobials

  • Florian M. E. Wagenlehner
  • Wolfgang Weidner
  • Kurt G. Naber
Chapter
Part of the Springer Specialist Surgery Series book series (SPECIALIST)

Abstract

Bacterial urinary tract infections (UTI) are frequently found in the outpatient as well as in the nosocomial setting. The bacterial UTI can be stratified into uncomplicated and complicated UTI and urosepsis.

Antimicrobial therapy is mostly guided by laboratory susceptibility testing. The scientific basis of antibiotic treatment relies on pharmacodynamic and pharmacokinetic parameters. The results of these correlations are summarized in the definition of susceptibility breakpoints. Antibiotic resistance is continuously increasing in uncomplicated as well as complicated UTI. A new aspect is therefore currently included in the concepts of antimicrobial treatment of bacterial UTI, which refers to the capacity of inducing emergence of antibiotic resistance of different antibiotic substances in different entities of UTI. In uncomplicated UTI, efforts are made to use antibiotic substances exclusively for this indication. In complicated UTI, antibiotics with optimal activity in the urinary tract and high dosage are recommended. The use of antibiotics has to keep up with the continuous change in antimicrobial resistance and the tailored needs in the individual patient. Antibiotic substances therefore need to become evaluated for each indication and continuously followed for clinical usage. The knowledge of structure-activity relationships of antimicrobial substances and bacterial resistance mechanisms to antibiotics help to use antibiotics better in daily routine and design new derivatives and substances.

Keywords

Urinary Tract Infection Antimicrobial Substance Complicated Urinary Tract Infection Uncomplicated Urinary Tract Infection Antibiotic Substance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer London 2011

Authors and Affiliations

  • Florian M. E. Wagenlehner
    • 1
  • Wolfgang Weidner
    • 2
  • Kurt G. Naber
    • 3
  1. 1.Department of Urology, Pediatric Urology and AndrologyJustus-Liebig-UniversityGiessenGermany
  2. 2.Department of Urology, Pediatric Urology and AndrologyUniversity Hospital Giessen and Marburg GmbHGiessenGermany
  3. 3.Technical University of MunichMunichGermany

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