Urinary tract infections relapses

Chronic bacterial prostatitis occurs when acute bacterial prostatitis has been inadequately treated because of pathogen resistance, relapse, or short-course therapy or because of blocked drainage of secretions from the prostate. Most men with chronic prostatitis will have had a previous bout of acute prostatitis. The most common clinical feature of chronic prostatitis is recurrent urinary tract infections and the symptoms and complaints of acute bacterial prostatitis. Fluoroquinolones, trimethoprim-sulfamethoxazole, doxycycline, and nitrofurantoin are used in the management of chronic prostatitis. Chronic prostatitis warrants at least 10 to 12 weeks of therapy. Poor clinical outcomes, however, have been observed because of poor diffusion of antimicrobials into the prostate. 

The remaining 20% of recurrent UTIs are relapses, i.e., persistence of infection with the same organism after therapy for an isolated UTI. The recurrence of symptomatic or asymptomatic bac-teriuria after therapy usually indicates that the patient has renal involvement, a structural abnormality of the urinary tract, or chronic bacterial prostatitis. In the absence of structural abnormalities, relapse often is related to renal infection and requires a long duration of treatment. Women who relapse after short-course therapy should receive a 2-week course of therapy. In patients who relapse after 2 weeks of therapy, therapy should be continued for another 2 to 4 weeks. If relapse occurs after 6 weeks of therapy, urologic evaluation should be performed, and any obstructive lesion should be corrected. If this is not possible, therapy for 6 months or longer may be considered. Asymptomatic adults who have no evidence of urinary obstruction should not receive long-term therapy. 

UTls are one of the most common bacterial infections in humans. Most of these infections follow instrumentation of the urinary tract, mainly urinary catheterization see Fig. 3), with the development of catheter-associated bacteriuria directly related to the duration of catheterization (18). BPI easily allows spatial information to be monitored sequentially throughout the entire disease process, from cystitis to ascending UTIs see Fig. 4 and Color Plate 8, following p. 46), as well as treatment efficacy and relapse in diseased or asymptomatic animals all without exogenous sampling (10). 

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