MP23-08 LACK OF UNIFORMITY AMONG UNITED STATES GUIDELINES FOR DIAGNOSIS & MANAGEMENT OF ACUTE, UNCOMPLICATED CYSTITIS

Abstract

and Embase for the period 2008-2015, randomized controlled trials and systematic reviews with or without meta-analysis were included. Within the framework of a guideline synopsis, relevant guidelines were sought. Evidence level and bias risk were used for quality testing.RESULTS: Particular emphasis is given to symptom-oriented diagnostics. Fosfomycin trometamol, nitrofurantoin, nitroxolin, pivmecillinam or trimethoprim are recommended equivalently for the treatment of uncomplicated cystitis. Fluoroquinolones and cephalosporins are not recommended. For uncomplicated slight-moderate pyelonephritis preferably the oral formulations namely cefpodoxim, ceftibuten, ciprofloxacin or levofloxacin are recommended. An asymptomatic bacteriuria is not to be treated. In recurrent urinary tract infections, non-antibiotic prevention measures are recommended.CONCLUSIONS: Physicians, who are involved in the treatment of uncomplicated urinary tract infections, should familiarize themselves with the revised recommendations for the selection and dosage of antibiotic therapy of the updated clinical guideline. Antimicrobial stewardship aspects have significantly influenced the therapeutic recommendations. A broad implementation in all treatment groups is necessary to ensure a sustainable antibiotic policy and to improve care.