• Corina Nemirovsky, María José López Furst, Daniel Pryluka, Lautaro De Vedia, Pablo Scapellato, Angel Colque, Laura Barcelona, Javier Desse, Matías Caradonti, Daniel Varcasia, Gagriel Ipohorski, Roberto Votta, Marcelo Zylberman, Adriana Romani, Pascual Valdez, Flavia Amalfa, Celeste Lucero, Adriana Fernández Lausi, Alejandro Fernández Garces, Claudia Rodríguez, Ana Chattas, Javier Farina, Liliana Clara, Yanina Nuccetelli, and Grupo de trabajo del Consenso Argentino de Infección Urinaria.
• Sociedad Argentina de Infectología, Argentina. E-mail: corina.nemirovsky@hospitalitaliano.org.ar.
• Medicina (B Aires). 2020 Jan 1; 80 (3): 241-247.

AbstractThe second part of the Inter-Society Argentine Consensus on Urinary Tract Infection (UTI) includes the analysis of special situations. In patients with urinary catheter, urine culture should be requested only in the presence of UTI symptomatology, before instrumentation of the urinary tract, or as a post-transplant control. The antibiotics recommended for empirical treatment in patients without risk factors are third-generation cephalosporins or aminoglycosides. UTIs associated with stones are always considered complicated. In case of obstruction with urosepsis, an emergency drainage should be performed via a percutaneous nefrostomy or ureteral stenting. In patients with stents or ureteral prostheses, such as double J catheters, empirical treatment should be based on epidemiology, prior antibiotics, and clinical status. Before the extracorporeal lithotripsy procedure, bacteriuria should be investigated and antibiotic prophylaxis should be administered in case of positive result, according to the antibiogram. First generation cephalosporins or aminoglycosides are valid alternatives. The use of antibiotic prophylaxis with first-generation cephalosporins or aminoglycosides before percutaneous nephrolithotomy is recommended. Transrectal prostatic biopsy can be associated with infectious complications, such as UTI or acute prostatitis, mainly due to Escherichia coli or other enterobacteria. In patients without risk factors for multiresistant bacteria and negative urine culture, prophylaxis with intravenous amikacin or ceftriaxone is recommended. In patients with positive urine culture, prophylaxis will be performed according to the antibiogram, from 24 hours before to 24 hours post-procedure. For the targeted treatment of post-transrectal biopsy prostatitis, carbapenems for 3-4 weeks are the treatment of choice.

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