Juraj Hromec, Silvester Krčméry, Zuzana Straková - Gábrišová, Rastislav Tahotný
Therapy of urinary infections is a frequent problem in inpatient and outpatient practice. Chemotherapeutics is the most suitable therapy. They reach high and prolonged levels in urine, they have advantageous pharmacokinetics and minimal adverse effects. Fluorochinolones, kotrimoxazol, betalaktamase antibiotics, nitrofurantoin, and phosphomycin - trometamol are frequently used. The occurrence of recurrent cystitis is the commonest complication of women. Beneficial effect of long term prophylactic administration of small doses of chemotherapeutics is generally accepted in this indication. Renaissance has been reported in immunotherapy. In clinical practice infections in hepatobiliary tract are often seen. Very often (in 90 % of cases) disorder of bile discharge is present, which is caused by biliary lithiasis. Enterobacteriacae predominate as infectious agens and Bacteroides and Clostridium spp as anaerobes. Mixed infections are also possible the fact that is considered in potential antimicrobial therapy. Drugs of the first choice are penicillines enhanced by betalactamase inhibitors, cephalosporines or karbapenemes. If anaerobe infection is suspected metronidazol or klindamycine is added to the therapy.