Urethritis, bacterial N34.1

Author: Prof. Dr. med. Peter Altmeyer

Last updated on: 13.11.2023

Synonym(s)

mimic urethritis; Urethritis Coliurethritis; Urethritis Staphylococcal urethritis; Urethritis Streptococcus urethritis; Urinary tract infection

Definition
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Urethritis caused by various pathogens, especially pseudogonococcus, mimeae, coliform bacteria (coliurethritis), staphylococci (staphylococcus urethritis), streptococci (streptococcus urethritis), Proteus species, Pseudomonas aeruginosa and Klebsielles. It belongs to the non-specific urethritides.

General therapy
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Cooperation with urologists. If possible, 2-3 liters of fluid intake daily, especially mildly disinfecting teas (e.g. mixed teas from bearberry, Hauhechel root, birch leaves, etc.)

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External therapy
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Not necessary. Local antibiotics, glucocorticoid-containing styli or insertions are not indicated, they carry the risk of grafted traumatic urethritis.

Internal therapy
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Antibiosis according to antibiogram. Primary treatment with cotrimoxazole (e.g. Eusaprim) dosage: 80/400 mg.
Alternative: Gyrase inhibitors such as ciprofloxacin (e.g. Ciprobay) 2 times/day 0.25-0.5 g p.o. for 7-10 days, ofloxacin (e.g. Tavanic) 2 times/day 200-400 mg p.o. or i.v. or norfloxacin (Barazan) 400 mg every 12 hrs p.o. for 7-10 days.
Alternative: Doxycycline (e.g. Doxy-Wolff) 100 mg p.o. 2 times/day for 1 week or azithromycin (e.g. Zitromax) 1 g p.o. as a single dose.
D-mannose orally - binds the pili of enterococci so that they can no longer attach to the urothelia. Preparation: Femannose® N Dosage in acute bladder infections: 1st-3rd day 3 sachets, 4th and 5th day 2 sachets/day. Prophylactic: 1 sachet/day.

Phytotherapy internal
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see also under Urinary tract infection, internal phytotherapy. With the increase in resistance to antibiotics, herbal remedies are increasingly coming to the fore. A distinction should be made here between aquaretics (plant-based diuretics), urinary tract disinfectants, micturition-influencing agents and agents against urinary stone formation.

Aquaretics and disinfectants are suitable for the treatment and prophylaxis of urethritis.

Aquaretics promote the blood circulation of the glomeruli of the kidney with an increase in the amount of primary urine. see under: Birch - Betulae folium, Goldenrod - Solidaginis herba, Hauhechel - Ononidis radix, Parsley - Petroselini herba, Juniper - Juniperi fructus and Cat's Bit - Orthosiphonis folium.

Urinary tract disinfectants act against microorganisms: see under bearberry - Uvae ursi folium, nasturtium - Tropaeoli maji herba, horseradish - Armoraciaerusticanae radix, cranberry - Vitisidaeae folium.

Literature
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Kranjčec B et al. (2014) D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World Journal of Urology 32: 79-84.
Zisser LA (2016) The power of medicinal plants specifically for the therapy of acute and chronic infections of the genitourinary tract. https://unipub.uni-graz.at/obvugrhs/content/titleinfo/1392005/full.pdf.