ALTERNATIVE TREATMENT OF UNCOMPLICATED URINARYTRACT INFECTION

Background and Aim : Urinary tract infections (UTIs) are among the most prevalent infectiousdiseases in general practice and of these, ۸۰% are classified as uncomplicated UTIs (uUTIs).Methods : Although current EAU guidelines recommend the use of antibiotics (ABs) as the firstchoice of treatment for the acute phase of uUTIs, several prospective randomized, placebocontrolledstudies have been performed already comparing antibiotic therapy with symptomatictherapy. These results were compelling enough for the updated German Clinical Guidelines toencourage the use of the non-AB symptomatic treatment in selected cases of acute lower uUTIswith mild-to-moderate symptoms and use the Acute Cystitis Symptom Score (ACSS) questionairefor the clinical diagnostics and patient-reported outcome in females with acute episodes of uUTI(cystitis).Results : If not only antibacterial agents but also alternative substances will be tested, clinicalcriteria should become the most important inclusion and outcome objectives. For the diagnosticsof uUTI not only the presence but also the severity (scoring) of the so-called typical symptoms areimportant. Although, the presence of “a minimum number of symptoms such as frequency,urgency and dysuria AND documented pyuria” as suggested by the draft EMA guideline may havea reasonable sensitivity and specificity, to diagnose AC, for the definition of “clinical cure” ascoring system is also necessary, because it cannot be expected that in all patients with favourableclinical outcome all so-called typical symptoms will have been disappeared.Conclusion : . In female patients with acute uUTI the Acute Cystitis Symptom Score (ACSS)questionaire already validated in several languages could be a suitable tool for better defineddiagnostics and patient-reported outcome to define better clinical cure and failure in well designedclinical and epidemiological studies and for self-treatment.

کلیدواژه ها:

uncomplicated urinary tract infection ، acute cystitis ، female patients ، Acute CystitisSymptom Score ، ACSS ، questionaire.