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Latin American consensus on uncomplicated recurrent urinary tract infection—2018

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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.

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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.

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Authors and Affiliations

  1. Faculdade de Medicina da Universidade de São Paulo, Rua Dr Renato Paes de Barros 901 ap 72, Itaim, São Paulo, 04530000, Brazil

    Jorge Milhem Haddad

  2. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Enrique Ubertazzi

  3. Hospital Padre Hurtado, Universidad del Desarrollo, San Ramón, Chile

    Oscar Storme Cabrera

  4. Hospital Nacional Docente Madre-Niño San Bartolome, Lima, Peru

    Martha Medina

  5. Clínica del Country del Country, Bogota, Colombia

    Jorge Garcia

  6. National Institute of Perinatology, Mexico City, Mexico

    Silvia Rodriguez-Colorado

  7. Faculdade de Medicina, UNAN León-Universidad Nacional Autónoma de Nicaragua, León, Nicaragua

    Efrain Toruno

  8. Department of Gynecology, Universidade de São Paulo, Sao Paulo, Brazil

    Priscila Katsumi Matsuoka

  9. Hospital de Clínicas “Dr. Manuel Quintela”, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay

    Edgardo Castillo-Pino

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  1. Jorge Milhem Haddad
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  5. Jorge Garcia
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Correspondence to Jorge Milhem Haddad.

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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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Haddad, J.M., Ubertazzi, E., Cabrera, O.S. et al. Latin American consensus on uncomplicated recurrent urinary tract infection—2018. Int Urogynecol J 31, 35–44 (2020). https://doi.org/10.1007/s00192-019-04079-5

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