M.V. Mitchenko

Acute uncomplicated pyelonephritis. Efficiency of etiotropic therapy patients in the presence of infection of urine and genital tracts by bacterias and mollicutes

The study was conducted in 93 patients with acute uncomplicated pyelonephritis and concomitant inflammatory diseases of the genitals. Patients are divided into research (additional treatment by a gynecologist according to the proposed scheme) and two comparison groups (classical therapy). In the hospital, emergency empirical antibiotic therapy with cephalosporins and fluroquinolones was carried out. After discharge from the hospital, patients of the main group infected with mollicutes (mycoplasmas, ureaplasmas) were observed by a gynecologist and received doxycycline and fluconazole. Next, specific immunotherapy was carried out with human immunoglobulins against mycoplasmas and ureaplasmas and therapy with probiotics Biosporin and Lactobacterin.

A follow-up examination documented a good clinical, laboratory and microbiological result in 82,4% patients. The number of visits to the urologist regarding recurrent cystitis and acute pyelonephritis decreased from 74,2% to 17,6% in patients of the research group (on average from 1,16 to 0,35 cases per year).

The proposed combination therapy increases the effectiveness of treatment, providing eradication of both classical bacteria and mollicutes not only from the urinary tract, but also from the genital tract, which are the source of infection, thus preventing recurrence of urinary infection.