Infekcije mokraćnog sustava (IMS) jesu simptomatske,
asimptomatske, akutne (prve ili pojedinačne),
rekurentne, kronične, komplicirane i nekomplicirane. Klinički
simptomi cistitisa i leukociturija dovoljan su razlog za
počinjanje trodnevne empirijske antimikrobne terapije akutnoga
nekompliciranog cistitisa u mladih žena. Urinokultura se
mora učiniti prije počinjanja antimikrobne terapije u trudnica,
dijabetičara, rekurentnih IMS, pijelonefritisa i ako nije bilo
uspješnoga ranijeg liječenja. Liječiti treba sve simptomatske
IMS, a asimptomatsku bakteriuriju samo u trudnica, dijabetičara,
predškolske djece s abnormalnim urotraktom,
novorođenčadi i prije urološko-ginekoloških zahvata te kod
primalaca transplantiranog bubrega. Kod kompliciranih IMS
važno je utvrditi i pokušati ukloniti ili bar staviti pod kontrolu
čimbenike koji tu IMS čine kompliciranom. Za liječenje IMS
upotrebljavaju se fluorokinoloni, betalaktamski antibiotici,
aminoglikozidi, kotrimoksazol, nitrofurantoin i drugi. Cistitis
se može liječiti 3 ili 7 dana, asimptomatska bakteriurija 3-7
dana, nekomplicirani pijelonefritis 10-14 dana. Za kronične i
komplicirane IMS preporučuje se 7-14-dnevno liječenje samo
u relapsima i reinfektima, a u odabranih bolesnika viπe
tjedana do 6 mjeseci. Kemoprofilaksa rekurentnih nekompliciranih
IMS provodi se najmanje 6 mjeseci.Urinary tract infections (UTI) are symptomatic,
asymptomatic, acute (first or single), recurrent, chronic,
complicated and uncomplicated. Clinical symptoms of cystitis
and leukocituria are reasons enough to start a 3-day
empiric antimicrobic therapy of acute uncomplicated cystitis
in young women. Urinoculture must be done before the onset
of antimicrobic therapy in pregnant women, diabetics, recurrent
UTI, pyelonephritis, and in cases of unsuccessful previous
treatment. Treated should be all symptomatic UTI, while
asymptomatic bacteriuria should be treated only in pregnant
women, diabetics, pre-school children with abnormal urinary
tract, newborns and before urological-gynecological surgery
as well as in receptors of transplanted kidney. In complicated
UTI it is important to establish and to try to eliminate, or
at least to control, factors which complicate the particular
case. For treatment of UTI are used fluorokinolons, beta-lactamic
antibiotics, aminoglykosides, cotrimoxazole, nitrofurantoin
etc. Cystitis can be treated 3 or 7 days, asymptomatic
bacteriuria 3 to 7 days, uncomplicated pyelonephritis
10 to 14 days. For chronic and complicated UTI 7 to 14 days
treatment is recommended only in relapses and reinfections,
and in chosen patients for several weeks, up to 6 months.
Chemoprophylaxis of recurrent uncomplicated UTI is performed
for at least 6 months
