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Berlin The German Society for Urology (DGU) has presented an updated S3 guideline on the epidemiology, diagnostics, therapy, prevention and management of uncomplicated, bacterial, community-acquired urinary tract infections in adults. The Innovation Committee of the Federal Joint Committee (G-BA) has funded the basic project work for the guideline.

If an acute, uncomplicated urinary tract infection remains limited to the bladder, serious complications are not to be expected even in recurrent episodes, the group of authors initially makes clear.

The diagnosis of a urinary tract infection and the indication for antibiotic therapy should therefore be made critically in order to avoid unnecessary therapies and the development of resistance, the guideline continues.

The guideline group was able to draw on new data on the supply and prescription situation as well as on current resistance data in different regions.

These data form the basis for the recommendations for the prescription of antibiotics. At the same time, they are the basis for any non-antibiotic therapy that may be possible. Overall, a saving of 63 percent in antibiotics was achieved across all studies through non-antibiotic acute therapy, reports the group of authors.

Doctors should therefore consider non-antibiotic therapy as an alternative to antibiotic treatment in acute uncomplicated cystitis in non-geriatric patients. Participatory decision-making with the patients is necessary, the guideline states.

The guideline describes possible collateral damage caused by different antibiotics and explicitly takes this into account in the recommendations. A new chapter in this version of the guideline is a chapter on geriatric patients with and without catheters. Children and adolescents were explicitly excluded from the search strategy. © hil/aerzteblatt.de