MENDES, Roseany de Sousa.
Résumé:
Urinary tract infection (UTI) is considered one of the most frequent infections in medical practice and the second largest in the world population, reaching women and men. Risk factors for UTI include: chronic carriers of urinary catheters, urinary tract outflow obstruction, neurogenic bladder, diabetes, diaphragm use, pregnancy, use of spermicide-coated condoms, congenital urinary tract abnormalities. The bacteria in UTIs have undergone progressive changes on resistance profile to antibiotics commonly used in clinical practice. Therefore, it is necessary to know the etiology and the resistance profile of microorganisms causing UTIs, aiming a better choice of therapy, minimizing resistance increase and spread of multiresistant pathogens. Objectives: This study aimed to search the literature of drugs used for treatment of UTI, identifying the uropathogens and the kinds of prevalent infections. Methodology: A systematic review was conducted in the electronic databases SciELO, CAPES, Bireme for articles published in the last seventeen years. Literature search included original articles, review articles, articles published in magazines, editorials written in English and Portuguese. Results and Discussion: Among the commonly isolated organisms in UTI, E. coli and Klebsiella spp. were the most prevalent, followed by Enterobacter spp., Staphylococcus spp. and Proteus spp. The most mentioned clinical manifestations were: Upper Urinary Tract Infections involving the renal parenchyma (pyelonephritis), ureters (ureterites) or cause renal abscesses; Lower Urinary Tract Infections involving the bladder (cystitis), urethra (urethritis) and, in men, the epididymis (epididymitis) and the prostate (prostatitis). Antibacterial drugs most commonly used to treat UTIs were penicillins, cephalosporins, aminoglycosides, quinolones and sulfonamides. The choice of antimicrobial therapy for UTI varies with the presentation of the infection, the host and the agent. Strategies involving different therapeutic regimens, according to specific patient groups, aim to maximize therapeutic benefits and minimize the incidence of adverse effects and the occurrence of resistant microorganisms. Conclusions: The choice of the appropriate therapeutic regimen is very important for the treatment of UTI. Thus, a need exists to analyze the drugs that act directly on the agent of urinary tract infection, helping significantly to the non-appearance and spread of bacterial resistance. This kind of study may contribute to a better orientation in the prescription of appropriate antimicrobials in the treatment of this pathology.
