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A Fitoterapia na profilaxia e terapêutica de infeções do trato urinário não complicadas: o caso particular da cistite
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Abstract(s)
As infeções do trato urinário (ITUs) afetam cerca de 150 milhões de pessoas por ano, de todas as idades em todo o mundo e constituem as infeções bacterianas mais comuns a nível comunitário e hospitalar, sendo consideradas o segundo maior processo infecioso após as infeções respiratórias. Estas infeções têm um elevado impacto não só a nível económico, como também a nível pessoal, uma vez que os seus sintomas afetam consideravelmente a qualidade de vida dos doentes.
São muitos os agentes etiológicos que podem causar uma ITU, no entanto considera-se que a Escherichia coli uropatogénica é o principal agente etiológico quer nas ITUs não complicadas, quer nas ITUs complicadas. As ITUs mais prevalentes na população são a cistite e a pielonefrite. Estas diferem no local de infeção, nos sintomas associados, no seu diagnóstico, bem como no seu tratamento farmacológico. De um modo geral, o tratamento de ambas as patologias, passa pelo uso de antibióticos de forma empírica, no entanto, cada vez mais os microrganismos causadores das ITUs estão a tornar-se resistentes ao uso dos antibióticos, pelo o que é necessário, para além da criação de novos antibióticos, recorrer a outras terapêuticas alternativas para contornar esta problemática.
Neste sentido, a presente dissertação pretende apresentar numa primeira instância vários aspetos da patologia, nomeadamente, as diversas ITUs existentes, os fatores de risco, as vias de infeção, os principais agentes etiológicos e abordar mais detalhadamente a cistite e a pielonefrite por serem as ITUs mais comuns, clarificando as principais diferenças em termos de sintomatologia e diagnóstico. São apresentadas, também, as diversas medidas a adotar como terapêutica não farmacológica, os diversos fármacos usados na terapêutica farmacológica da cistite e pielonefrite e as diversas medidas profiláticas existentes.
Na última parte da dissertação, pretende-se dar especial atenção ao papel da fitoterapia como terapêutica e profilaxia das ITUs não complicadas em alternativa à administração de antibióticos, principalmente na cistite que é a infeção urinária em que a fitoterapia poderá ter um papel importante. Por último, evidencia-se o papel do farmacêutico comunitário, bem como as preparações à base de plantas mais utilizadas nesta patologia.
Urinary tract infections (UTIs) affect about 150 million people each year worldwide and are the most common bacterial infections at community and hospital level and are considered the second major infectious disease after respiratory infections. These infections have a high impact not only economically, but also on a personal level, as its symptoms significantly affect the patient’s quality of life. There are many etiologic agents that can cause UTI, however uropathogenic Escherichia coli is considered the main etiologic agent in both uncomplicated UTIs and complicated UTIs. The most prevalent UTIs in the population are cystitis and pyelonephritis. These differ in the site of infection, in the associated symptoms, in its diagnosis, as well as in its pharmacological treatment. In general, the treatment of both pathologies involves the use of antibiotics in an empirical way, however, more and more the microorganisms that cause UTIs are becoming resistant to the use of antibiotics, so it is necessary besides the creation of new antibiotics, to resort to other alternative therapies to overcome this problem. In this sense, the present dissertation intends to present in the first instance several aspects of the pathology, namely, the various existing UTIs, the risk factors, pathways of infection, main etiological agents, and to discuss cystitis and pyelonephritis in more detail because they are the most common UTIs, clarifying the main differences in symptomatology and diagnosis. The different measures to be adopted as non-pharmacological therapy, the various drugs used in the pharmacological treatment of cystitis and pyelonephritis, and the various prophylactic measures are also presented. In the last part of the dissertation, it is intended to pay special attention to the role of phytotherapy as therapeutics and prophylaxis of uncomplicated UTIs as an alternative to the administration of antibiotics, especially in cystitis which is the urinary infection in which herbal medicine may play an important role. Finally, show the role of the community pharmacist as well as the most commonly used herbal preparations in this pathology.
Urinary tract infections (UTIs) affect about 150 million people each year worldwide and are the most common bacterial infections at community and hospital level and are considered the second major infectious disease after respiratory infections. These infections have a high impact not only economically, but also on a personal level, as its symptoms significantly affect the patient’s quality of life. There are many etiologic agents that can cause UTI, however uropathogenic Escherichia coli is considered the main etiologic agent in both uncomplicated UTIs and complicated UTIs. The most prevalent UTIs in the population are cystitis and pyelonephritis. These differ in the site of infection, in the associated symptoms, in its diagnosis, as well as in its pharmacological treatment. In general, the treatment of both pathologies involves the use of antibiotics in an empirical way, however, more and more the microorganisms that cause UTIs are becoming resistant to the use of antibiotics, so it is necessary besides the creation of new antibiotics, to resort to other alternative therapies to overcome this problem. In this sense, the present dissertation intends to present in the first instance several aspects of the pathology, namely, the various existing UTIs, the risk factors, pathways of infection, main etiological agents, and to discuss cystitis and pyelonephritis in more detail because they are the most common UTIs, clarifying the main differences in symptomatology and diagnosis. The different measures to be adopted as non-pharmacological therapy, the various drugs used in the pharmacological treatment of cystitis and pyelonephritis, and the various prophylactic measures are also presented. In the last part of the dissertation, it is intended to pay special attention to the role of phytotherapy as therapeutics and prophylaxis of uncomplicated UTIs as an alternative to the administration of antibiotics, especially in cystitis which is the urinary infection in which herbal medicine may play an important role. Finally, show the role of the community pharmacist as well as the most commonly used herbal preparations in this pathology.
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Keywords
Infeções do Trato Urinário não complicadas Cistite Pielonefrite Fitoterapia Terapêutica Profilaxia