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Immunotherapy and long‑term chemoprophylaxis in prevention of recurrent urinary infections in women


Authors: S. Krčméry 1;  J. Hromec 2;  Z. Gábrišová 1;  R. Tahotný 1
Authors‘ workplace: II. klinika geriatrie Lekárskej fakulty UK a FNsP Milosrdní bratia, spol. s r. o., Bratislava, Slovenská republika, prednosta doc. MU Dr. Silvester Krčméry, CSc. 1;  Interná klinika FZaSP a FNsP Trnava, Slovenská republika, prednosta prof. MU Dr. Juraj Hromec, CSc. 2
Published in: Vnitř Lék 2010; 56(9): 955-960
Category: 60th Birthday - Andrej Dukat MD, Csc., FESC

Overview

In clinical practice, management of urinary infections is a frequent task. Long‑term prophylactic administration of small‑dose chemotherapy had been shown to prevent recurrent urinary infections. Recently, an interest increases in applying immunotherapy in this indication. The authors compare immunomodulators Urovaxom and Luivac as part of a combined immunotherapy and chemoprophylaxis regimens with small doses of fluorochinolones over 12 months in women with recurrent urinary infections. This treatment statistically significantly decreases occurrence of relapses and has been relatively well‑tolerated. Unlike previous studies, we managed to isolate resi­stant strains producing the so‑ called extended‑ spectrum β‑ lactamases (ESBL) and this may provide a signal for revision of some therapeutic approaches. In line with international recommendations, we prefer immunotherapy as comparably effective but safer treatment modality than the long‑term chemoprophylaxis with fluorochinolones.

Key words:
urinary infections –  combined chemoprophylaxis and immunotherapy –  relapse prevention


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Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 9

2010 Issue 9

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