How to treat recurrent urinary tract infections?

Recurrent urinary tract infections, including relapse and re-infection of two types. Relapse is the original infection has not completely kill the bacteria and stop the treatment of a re-growth and reproduction, cause disease, Recurrence majority of the patients have symptoms of urinary tract infection. Relapse indicate that the original treatment failure or incomplete. Common reasons for failure are : (a) poor choice of antibiotics : Antibiotics effective against some bacteria or totally ineffective. (2) The concentration of antibacterial inadequate : Pyelonephritis, most of focal lesions, lesions were more than a scar formation Department inadequate blood flow, leading to lesions drug concentration insufficient to eliminate intralesional bacteria, only serve to suppress bacterial growth and activities of the role of withdrawal to revive the bacteria, caused the recurrence. In light of this situation, the use of bacteria-sensitive bactericidal drugs such as gentamicin and penicillin. infected parts of the effective treatment of drug concentration and often achieve better results. (3) L-type bacteria : L-type is a bacterial cell wall-deficient bacteria, the permeability environmental resistance to a certain extent, In hypertonic environment can not survive, once to stop treatment, the L-type bacteria recovery, and continue to pathogenicity. Because the L-type bacteria in isotonic or hypotonic medium growth is not easy, the general negative urine culture. Pyelonephritis recurrence, about 20% by L-type bacteria. Treatment of recurrence inhibit protein synthesis can be used antibiotics, such as tetracycline, erythromycin and chloramphenicol or Gentamycin. (4) urinary calculi : urolithiasis recurrent infection is a common cause, infectious stones center can often isolated urease decomposition of bacteria, antibiotics it invalid, even after removing the stone, Infection is still often relapse, this residual bacteria and micro-calculus, it can be used stones after 10% Renacidin or rinse agent. (5) the emergence of resistant strains : Generally rare in the treatment of early-resistant strains, but accompanied by renal dysfunction, antibacterial agents in the kidney achieve an effective concentration is very slow, so the conditions under which the emergence of drug-resistant bacteria. A further possibility is that the treatment is at the beginning of resistant strains in the treatment within 72 hours of urine bacteria have not vanished symptoms still exist, should be replaced drug susceptibility testing. (6) dose regimen is too short or not : So many medical centers, based on the recommendations susceptibility test results Antibiotics sensitive choice, within the permissible range of oral dose for six weeks course of treatment. Reinfection is the last of urinary tract infection symptoms after treatment disappeared, urine negative bacteria, after a period of time, Another different with the original re-invasive bacterial urinary tract and causing infections. Re-infection more common in women, often for cystitis, the majority of cases re-infection with symptoms of urinary tract infection, treatment methods and the same as the first attack, but after treatment should advise patients to the prevention of urinary tract infection. If medication to prevent further infection, the drug at low doses should be effective and have less side effects. and the large intestine flora composition and the sensitivity of antibacterials has little impact. At present, the most commonly used for long-range low-dose antibiotic therapy is cotrimoxazole, every night before bed to urinate after serving half tablets (TMP40mg, SMZ200mg), the method has been applied to the prevention, urinary tract infection recurrence rate per patient per year on average only 0.2 times. Allergic to sulfa drugs to the patients, can only TMP, bedside serving 50-100mg, its efficacy similar. Fluoride can also use the service every night hydrochloride acid 0.1 g, instead of cotrimoxazole for preventive treatment.