Vahlensieck W, Scheffer K
Fachklinik Urologie, Kurpark-Klinik, Kurstr. 41-45, 61231, Bad Nauheim, Deutschland.
Allgemeinmedizin, Labor Service, München, Deutschland.
Urologe A. 2021 Jan;60(1):52-58. doi: 10.1007/s00120-020-01289-4.
Increasing rates of multidrug resistant bacteria demand a change in managing infectious diseases. New ways of antibiotic-free treatment in uncomplicated urinary tract infections (UTI) saving antibiotics for severe infections should be chosen.
Beside analgesics for purely symptomatic treatment, herbal medicine can be used for uncomplicated UTI instead of antibiotics.
Anti-infectious phytodrugs like isothiocyanates (ITC) from horseradish and cress (nasturtium) have been thoroughly examined scientifically.
ITC showed multitarget effects in many pharmacological studies. Beside anti-inflammatory effects, a broad spectrum of species, including multiresistant bacteria were covered. Positive results and good compatibility are documented in several studies for therapy of uncomplicated UTI and respiratory infections with horseradish and cress as well as for prophylaxis in recurrent UTI (recommendation in the German S3 guideline for uncomplicated urinary tract infections, AWMF registry 043/044, statement 8.1.d.4 on prophylaxis).
Using isothiocyanates (ITC) for therapy and prophylaxis in uncomplicated urinary tract infections is a rational approach and helps to save antibiotics. Even after long-term use, development of resistance has not yet been observed and is not probable due to the multimodal mechanism of action of ITC.
多重耐药菌的发生率不断上升，这就需要改变传染病的管理方式。对于单纯性尿路感染（UTI），应选择无抗生素治疗的新方法，将抗生素留用于治疗严重感染。
除了用于单纯对症治疗的镇痛药外，草药可用于治疗单纯性尿路感染，替代抗生素。
对来自辣根和水田芥（旱金莲）的异硫氰酸盐（ITC）等抗感染植物药进行了全面的科学研究。
ITC在许多药理研究中显示出多靶点作用。除抗炎作用外，还涵盖了包括多重耐药菌在内的多种菌种。多项研究记录了使用辣根和水田芥治疗单纯性尿路感染和呼吸道感染以及预防复发性尿路感染的积极结果和良好的耐受性（德国关于单纯性尿路感染的S3指南推荐，AWMF登记号043/044，预防声明8.1.d.4）。
使用异硫氰酸盐（ITC）治疗和预防单纯性尿路感染是一种合理的方法，有助于节省抗生素。即使长期使用，尚未观察到耐药性的产生，并且由于ITC的多模式作用机制，耐药性也不太可能产生。
