Urologie pro praxi 1/2021

Current trends in antibiotic profylaxis in urology

Urinary tract infection (UTI) is an inflammatory response of the urothelium to bacterial invasion that is usually associated with bacteriuria and pyuria. Infection of the urinary tract occurs when bacterial virulence increases and/or host defense mechanisms decrease. Antimicrobial prophylaxis is the prevention of reinfections of the urinary tract by the administration of antimicrobial drugs. If the term is used correctly in reference to the urinary tract, it can be assumed that bacteria have been eliminated before prophylaxis is begun. Perioperative antimicrobial prophylaxis entails administration of an antibiotic agent before and for a limited time after a procedure to prevent local or systemic postprocedural infections. The article also deals with the prevention of UTI in other patient groups (elderly, children, people with established urinary catheters, neuro-urological patients, etc.). Metagenomic sequencing (MGS) is a new diagnostic approach that does not require bacterial isolation as we know it yet, but provides much more important information about the spectrum of microorganisms present in the urine sample at relatively low cost. Antimicrobial resistance has now become one of the most dangerous public health problems worldwide, also due to the excessive use and abuse of antibiotics in clinical practice.

Keywords: urinary tract infections, antibiotics, prophylaxis.