Izazovi u liječenju i prevenciji rekurentnih infekcija mokraćnog sustava

master's thesis

• Title (english): Challenges in treatment and prevention of recurrent urinary tract infections
• Author: Lučija Pap
• Mentor: Lidija Bach-Rojecky (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Sandra Jurić (član povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2022-07-01, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Rekurentnim infekcijama mokraćnog sustava smatraju se najmanje tri infekcije u godinu dana ili dvije infekcije u šest
mjeseci. Cilj ovog rada bio je prikazati relevantne smjernice u liječenju i prevenciji ovog sve učestalijeg zdravstvenog
problema. Poseban naglasak stavljen je na ulogu ljekarnika s obzirom da je ljekarnik najdostupniji zdravstveni djelatnik.
Najčešća terapija za liječenje akutnih i prevenciju rekurentnih infekcija jest antimikrobna, a korisni mogu biti i neantimikrobni pripravci i nefarmakološke mjere. Potrebno je razlikovati ne-antimikrobne pripravke koji se koriste
kratkotrajno u liječenju akutnih infekcija i ostale koji se koriste kroz dulji vremenski period u prevenciji. Najpoznatiji u
liječenju akutnih infekcija zasigurno je list medvjetke koji se smatra tradicionalnim biljnim lijekom. S druge strane, D-manoza ima vrlo snažne dokaze u prevenciji, usporedive čak s antimikrobnom profilaksom. Dokaze posjeduju još
brusnica, N-acetilcistein, probiotici (Lactobacillus spp.), cjepiva, hormonska nadomjesna terapija i glikozaminoglikani.
Infekcije mokraćnog sustava učestale su kod trudnica, a u tim situacijama liječi se i asimptomatska bakteriurija, i to u
prvom redu beta-laktamskim antibioticima, a u prevenciji se savjetuje koristiti brusnicu. Dodatan problem sprječavanju
ponavljajućih infekcija stvara bakterijska rezistencija koja raste iz godine u godinu. Utješna je činjenica da se na
nitrofurantoin kao prvu liniju liječenja i prevencije još nije razvila klinički značajna rezistencija. Uloga ljekarnika od
iznimne je važnosti u prevenciji i savjetovanju liječenja. Ljekarnik raspolaže znanjima o farmakološkoj terapiji, ali i o
biljnim pripravcima i ostalim dodatcima prehrani. Ključno je prepoznati situacije u kojima se ne preporuča samoliječenje
infekcija mokraćnog sustava i takve pacijente uputiti liječniku.

Abstract (english)

Urinary tract infections are recurrent when they occur at least three times in a year or two times in six months. Goal of
this paper was to present the most relevant guidelines in treatment and prevention of this increasingly common health
problem. Special emphasis was placed on the role of the pharmacist as the pharmacist is the most accessible health
professional. The most common therapy for the treatment of acute and prevention of recurrent infections is antimicrobial,
and the pharmacist, understanding the therapy prescribed by the doctor, has a wealth of knowledge about adjuvant
therapy, non-antimicrobial preparations and non-pharmacological measures. It is necessary to distinguish between nonantimicrobial preparations that are used for a short time in the treatment of acute infections and others that are used over a long period of time in prevention. The most famous in the treatment of acute infections is certainly the bearberry leaf,
which is considered a traditional herbal medicine. On the other hand, D-mannose has very strong evidence for
prevention, comparable even to antimicrobial prophylaxis. Cranberry, N-acetylcysteine, probiotics (Lactobacillus spp.),
Vaccines, hormone replacement therapy and glycosaminoglycans also have evidence. Urinary tract infections are
common in pregnant women, and in these situations asymptomatic bacteriuria is treated, primarily with beta-lactam
antibiotics, and in prevention it is advisable to use cranberries. An additional problem in preventing recurrent infections
is bacterial resistance that grows from year to year. It is comforting that nitrofurantoin as first-line in treatment and
prevention has not yet developed clinically significant resistance. The role of the pharmacist is extremely important in
prevention and treatment counseling. The pharmacist has knowledge of pharmacological therapy, but also of herbal
preparations and other dietary supplements. It is crucial to identify situations in which self-treatment of urinary tract
infections is not recommended. Those patients need to be referred to a doctor.

• Keywords: urinarne infekcije; mikroorganizmi; antimikrobni lijekovi; dodaci prehrani; prevencija; liječenje
• Keywords (english): urinary tract infections; microorganisms; antimicrobial drugs; dietary supplements; prevention; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:163:842691
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-07-13 09:14:42