Suppressive antimicrobial therapy for UTI
What is suppressive antimicrobial therapy and when should this be used?
Suppressive antimicrobial therapy is long-term antimicrobial therapy given to prevent symptomatic relapsing infection in selected patients with recurrent complicated UTI in whom infection cannot be eradicated.
Some examples include its use in men with frequent recurrent cystitis from a persistent prostate source; in kidney transplant patients with recurrent symptomatic infection from an infected native kidney; or or an individual with an inoperable infection stone to prevent further stone enlargement and preserve kidney function.
Antimicrobial therapy is selected based on the organism isolated from urine culture and considering patient tolerance. Initial treatment is for 2 to 4 weeks at the full therapeutic dose.
If this is effective and well tolerated, therapy is usually continued indefinitely at the lowest effective dose, which is usually one-half or less of the standard dose, or until the underlying abnormality is corrected.
