2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Acute Uncomplicated Cystitis

Ki Ho Kim; Seung-Ju Lee; Yong-Hyun Cho; Hyun-Sop Choe; Yong Gil Na; Jae Heon Kim; Hong Chung; Jae Min Chung; Jae Hung Jung; Hoon Choi; Sun-Ju Lee

doi:10.14777/uti.2017.12.01.03

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Kim, Lee, Cho, Choe, Na, Kim, Chung, Chung, Jung, Choi, and Lee: 2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Acute Uncomplicated Cystitis

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Urogenit Tract Infect 2017;12(1):3-6.

Published online: 19 April 2017

DOI: https://doi.org/10.14777/uti.2017.12.01.03

2017 Guidelines of The Korean Association of Urogenital Tract Infection and Inflammation: Acute Uncomplicated Cystitis

Ki Ho Kim, Seung-Ju Lee¹, Yong-Hyun Cho¹, Hyun-Sop Choe¹, Yong Gil Na², Jae Heon Kim³, Hong Chung⁴, Jae Min Chung⁵, Jae Hung Jung⁶, Hoon Choi⁷, Sun-Ju Lee^8,

Department of Urology, Dongguk University Gyeongju Hospital, Gyeongju

¹Department of Urology, College of Medicine, The Catholic University of Korea, Seoul

²Department of Urology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon

³Department of Urology, Soonchunhyang University Seoul Hospital, Sonchunhyang University College of Medicine, Seoul

⁴Department of Urology, Konkuk University Chungju Hospital, Chungju

⁵Department of Urology, Pusan National University School of Medicine, Yangsan,

⁶Department of Urology, Yonsei University Wonju College of Medicine, Wonju

⁷Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan

⁸Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea

Correspondence to: Sun-Ju Lee http://orcid.org/0000-0002-7195-2872 Department of Urology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea Tel: +82-2-958-8535, Fax: +82-2-959-6048 E-mail: sjlee@khu.ac.kr

Received 11 April 2017 Revised 13 April 2017 Accepted 13 April 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute uncomplicated cystitis is the most common urinary tract infection that mainly occurs in adult females, particularly sexually active young women and postmenopausal women. It is commonly observed in primary health care settings, including urology as well as obstetrics and gynecology; more than half of healthy adult women visit clinics and hospitals at least once in their lifetime due to acute uncomplicated cystitis. The most common bacterium causing this condition is Escherichia coli, followed by Staphylococcus saprophyticus, Klebsiella pneumoniae, Proteus mirabilis, and etc. Trimethoprim-sulfamethoxazole or fluoroquinolones have been used as an empirical antibiotic treatment. However, as fluoroquinolone-resistant organisms or extended spectrum beta-lactamase-producing organisms are becoming more prevalent worldwide, information on regional antibiotic resistance and guidelines on antibiotic use are becoming increasingly more desparate.

Keywords: Cystitis, Practice guideline

REFERENCES

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Fig. 1.

Algorithm for clinical management of acute uncomplicated cystitis (adapted from Asian Association of UTI & STI). UTI: urinary tract infection, ESBL: extended spectrum beta-lactamase, TMP-SMX: trimethoprim-sulfamethoxazole.

Table 1.

Criteria based on which to determine an empirical antibiotic therapy

Clinical consideration (confirmation of the absence of clinical symptoms of pyelonephritis such as high fever and flank pain, examination of disease history regarding complicated urinary tract infection such as diabetes)

Bacterial spectrum and sensitivity pattern

Treatment pattern and antibiotic resistance within the community

Availability, tolerability, history of sensitive response to drugs, and adverse effects

Cost

Compliance of the patient in the past

Table 2.

Empirical antibiotic treatment of acute uncomplicated cystitis

Antibiotics	Dosage (oral)	Duration (d)
Fosfomycin trometamol	3 g qd	1
Pivmecillinam^a)	400 mg tid	3
Nitrofurantoin macrocrystal^a)	100 mg bid	5-7
-Lactams
Amoxicillin-clavulanate	250/125 mg tid	7
	500/125 mg bid
Cefaclor	250 mg tid	7
Cefdinir	100 mg tid	5-7
Cefcapene pivoxil	100 mg tid	5-7
Cefpodoxime proxetil Fluoroquinolones	100 mg bid	5-7
Fluoroquinolones
Ciprofloxacin^b)	500 mg bid	3
Ciprofloxacin^b)	500 mg SR qd
Tosufloxacin^b)	150 mg bid	3

qd: once a day, tid: three times a day, bid: twice a day, SR: sustained-release.

^a) Unavailable in Korea as of April 2017,

^b) contraindicated in pregnant women.

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