Urogenital Tract Infection

Current Treatment of bacterial Urinary Tract Infection: Min Eui Kim; Korean J Urogenit Tract Infect Inflamm 2006;1(1):7-16. Published online October 31, 2006

Abstract PDF: Urinary tract infection (UTI) is one of the most common bacterial infections encountered in clinical practice in Europe and North America. It is estimated that 150 million cases of UTI occur on a global basis per year resulting in more than 6 billion dollars in direct health care expenditure1. Young, otherwise healthy, women are commonly affected with an estimated incidence of 0.5?0.7 infections per year2. Of the women affected 25?30% will go on to develop recurrent infections not related to any functional or anatomical urinary tract abnormality. Escherichia coli are the causative pathogen in approximately 70% to 95% and Staphylococcus saprophyticus in approximately 5% to 10% of acute uncomplicated cystitis. Occasionally other Enterobacteriaceae, such as Proteus mirabilis, Klebsiella sp, enterococci, or group B streptococci, are isolated from such patients. A similar distribution of uropathogens is found in acute uncomplicated pyelonephritis. The therapy of uncomplicated UTIs is almost exclusively antibacterial, whereas in complicated UTIs the complicating factors have to be treated as well. There are two predominant aims in the antimicrobial treatment of both uncomplicated and complicated UTIs: (1) rapid and effective response to therapy and prevention of recurrence of the individual patient treated; (2) prevention of emergence of resistance to antimicrobial chemotherapy in the microbial environment.
This article focuses on the current management of women with acute uncomplicated cystitis and pyelonephritis.(Korean J UTII 2006;1:7-16)

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Present and Future Strategies in the Treatment of Bacterial Urinary Tract Infection: Yong-Hyun Cho; Korean J Urogenit Tract Infect Inflamm 2006;1(1):17-22. Published online October 31, 2006

Abstract PDF: Bacterial urinary tract infections (UTIs) are common infectious diseases that can be associated with substantial morbidity and significant expenditures. The mainstay of management of UTIs is almost exclusively antibiotic agent. There are two predominant aims in the antibacterial treatment of UTIs: (i) rapid and effective response to therapy and prevention of recurrence of the individual patient treated; (ii) prevention of emergence of resistance to antimicrobial chemotherapy in the microbial environment. The main drawback of current antibiotic therapies is the emergence and rapid increase of antibiotic resistance. To combat this, active research is going on. This review highlights the current concepts and recent advances in our understandings and future treatment options for UTIs. (Korean J UTII 2006;1:17-23)

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Prevention of Emergence of Antibiotics Resistant Strains: Sun Ju Lee; Korean J Urogenit Tract Infect Inflamm 2006;1(1):23-26. Published online October 31, 2006

Abstract PDF: Effective strategies to prevent transmission or reduce the prevalence of resistant bacteria in hospitals include reducing antibiotic use, using antibiotics for which there is no resistance, decreasing length of hospital stays, instituting infection control measures to disrupt the spread of bacteria, nonspecific interventions that reduce transmission of all bacteria within a hospital, educating the hospitalstaff about the epidemiology, pathogenesis, and general routes of transmission of resistant bacteria. These strategies should adapt special situation (surgery patients, long-term admission/adult patients,pediatric patients). (Korean J UTII 2006;1:23?6)

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Guidelines for Antimicrobial Treatment of Urinary Tract Infections: Wan Shik Shin; Korean J Urogenit Tract Infect Inflamm 2006;1(1):27-30. Published online October 31, 2006

Abstract PDF: Urinary tract is the most common site among the bacterial infections. The purpose of this guideline is to provide the assistance to clinicians in the treatment of urinary tract infections(UTIs): uncomplicated, acute, symptomatic bacterial cystitis and acute pyelonephritis in women, asymptomatic bacteriuria, complicated UTIs, UTIs in men including prostatitis, and urinary catheter?associated infections. (Korean J UTII 2006;1:27?30)

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Practical Clinical Approach to Diagnosis and Update on Treatment of Syphilis: Seung-Ju Lee; Korean J Urogenit Tract Infect Inflamm 2006;1(1):31-38. Published online October 31, 2006

Abstract PDF: Syphilis is a systemic disease caused by Treponema pallidum. Syphilis is characterized by episodes of active disease(primary, secondary, tertiary stages) interrupted by periods of latency. The diagnosis of syphilis may involve dark?field microscopy of skin lesions but most often requires screening with a nontreponemal test and confirmation with a treponemal?specific test. Parenterally administered penicillin G is considered first?line therapy for all stages of syphilis. Alternative regimens for nonpregnant patients with no evidence of central nervous system involvement include doxycycline, tetracycline, ceftriaxone, and azithromycin. In pregnant women and congenital syphilis, penicillin remains the only effective treatment option; if these patients are allergic to penicillin, desensitization is required before treatment is initiated.. Once the diagnosis of syphilis is confirmed, quantitative nontreponemal test titers should be obtained. These titers should decline fourfold within six months after treatment of primary or secondary syphilis and within 12 to 24 months after treatment of latent or late syphilis. (Korean J UTII 2006;1:31-8)

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Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Guidelines for Antibiotic Therapy: In Rae Cho; Korean J Urogenit Tract Infect Inflamm 2006;1(1):39-44. Published online October 31, 2006

Abstract PDF: Antibiotic therapy is commonly prescribed empirically for prostatitis. It is important to use an agent with broad spectrum activity and preferential accumulation in prostatic fluid. So fluoroquinolones have become the standard of care for chronic bacterial prostatitis.
Management of CP/CPPS (chronic prostatitis/chronic pelvic pain syndrome) patients is still an enigma for the patient and the urologists as well. According to the best?evidence?based articles, a 4?week trial a of fluoroquinolone antibiotic for newly diagnosed, antibiotic?na?ve CP/CPPS men, but no further antibiotic therapy for CP/CPPS men with a more chronic condition who have failed antibiotics in the past. (Korean J UTII 2006;1:39-44)

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2006 EAU Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Treatment Guidelines: Duk Yoon Kim; Korean J Urogenit Tract Infect Inflamm 2006;1(1):45-53. Published online October 31, 2006

Abstract PDF: Advaces in research are changing the concept of the clinical management of chronic prostatitis, interstitial cystitis. As the new millennium begins, urologists and patients diagnosed with prostatits and interstitial cystitis can hope that exciting evolution will improve the dismal record for this disease. However, pain management is a subject afflicted by failure to identify its pathophysiological origins. The problem is most commonly experienced as 'interstitial cystitis (IC)' or 'chronic prostatitis (CP)'. The cause of chronic prostatitis (syndrome category IIIB) is not known, so causal treatment is a problem and many therapeutic options are justified on the basis of anecdote alone.
IC is a disease of the urinary bladder, which was first described by Skene in 1887. The ulcer, which is a typical cystoscopic finding in 10-50% of IC patients, was first described by Guy L. Hunner at the beginning of the last century. In 1949, when John Hand presented a large series of IC patients with varying endoscope and histopathological presentations, he realized that his material on IC did not comprise just one single entity. Cure is not currently a realistic goal so that symptom management is the only route to an improvement in quality of life. . Various medical and intravesical treatments have been proposed and investigated for IC.
When all efforts fail to relieve disabling IC symptoms, surgical removal of the diseased bladder represents an option. Three major techniques of bladder resection are common: supratrigonal (i.e. trigone-sparing) cystectomy, subtrigonal cystectomy, or radical cystectomy including excision of the urethra. All techniques require substitution of the excised bladder tissue, which is mostly performed with bowel segments. (Korean J UTII 2006;1:45-51)

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2006 CDC Sexually Transmitted Diseases Treatment Guidelines: Bong Suk Shim; Korean J Urogenit Tract Infect Inflamm 2006;1(1):54-67. Published online October 31, 2006

Abstract PDF: Center for Disease Control and Prevention (CDC) updated the sexually transmitted diseases (STDs) Treatment Guidelines, 2002 after consultation meeting Atlanta, Georgia, during April, 2005, and then developed the new guidelines for the treatments of STDs, 2006. Included in these updated guidelines are an expanded diagnostic evaluation for cervicitis and trichomoniasis; new antimicrobial recommendations for trichomoniasis; additional data on the clinical efficacy of azithromycin for chlamydial infections in pregnancy; discussion of the role of Mycoplasma genitalium and trichomoniasis in urethritis/cervicitis and treatment?related implications; emergence of lymphogranuloma venereum protocolitis among men who have sex with men; expanded discussion of the criteria for spinal fluid examination to evaluate for neurosyphilis; the emergence of azithromycin resistant Treponema pallidum; increasing prevalence of quinolone?resistant Neisseria gonorrhoeae in MSM; revised discussion concerning the sexual transmission of hepatitis C; postexposure prophylaxis after sexual assault; and an expanded discussion of STD prevention approaches.
These summaries rearranged 2006 CDC guidelines for the treatments of STDs around the urogenital STDs. Although these guidelines emphasize treatment, prevention strategies and diagnostic recommendations also are included. (Korean J UTII 2006;1:54-67)

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CP/CPPS: The Biomedical Model Has Failed! So What Is Next?: Bong Suk Shim; Korean J Urogenit Tract Infect Inflamm 2006;1(1):68-73. Published online October 31, 2006

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만성 고환통: 이길호; Korean J Urogenit Tract Infect Inflamm 2006;1(1):74-75. Published online October 31, 2006

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