A Systematic Review of Single-Dose Aminoglycoside Therapy for Urinary Tract Infection: Is It Time To Resurrect an Old Strategy?

Abstract

Increasing bacterial resistance and poor patient adherence rates limit the effectiveness of conventional antibiotic therapies for urinary tract infection (UTI). The objective of this study was to investigate whether a single aminoglycoside dose adequately treated UTI. A systematic search of PubMed/MEDLINE and Google Scholar databases was performed through September 2018 for English language original research articles assessing the efficacy of one-time parenteral aminoglycoside as UTI monotherapy. Of 252 potentially relevant studies, 13 studies met the inclusion criteria, representing 13,804 patients. Patient ages ranged from 2 weeks to >70 years; both inpatient and outpatient settings were represented. Cystitis was more common than pyelonephritis, and more females were represented than males.Escherichia coliwas the most commonly isolated uropathogen. The pooled microbiologic cure rate with single-dose aminoglycoside therapy was 94.5% ± 4.3%. Cure was sustained (no recurrence) for 73.4% ± 9.6% of patients at day 30. Lower cure rates were observed among patients with radiographic urinary tract abnormality (chi-squareP < 0.01). Across all studies, 63/13,804 (0.5%) cases of nephrotoxicity, vestibular toxicity, or injection site reaction were reported; no hearing loss was observed. Single-dose aminoglycoside therapy appears to be an effective treatment option for lower UTI in nonseptic patients, with minimal toxicity. Additional studies would be beneficial to confirm efficacy for pyelonephritis. When resistance to first-line UTI agents is endemic, aminoglycosides may serve as β-lactam- and fluoroquinolone-sparing options.

Molecular characterization of antimicrobial resistance and enterobacterial repetitive intergenic consensus-PCR as a molecular typing tool for Salmonella spp. isolated from poultry and humans

“…The strains isolated from human subjects with gastroenteritis were resistant to GM, which is one of the major antibiotics used in the treatment of urinary infections in humans [ 27 ]. On the other hand, all the Salmonella spp.…”

Aktuelle Entwicklungen im Bereich Antibiotic Stewardship

“…Als Substanzen, die über die Harnwege ausgeschieden werden, bieten sie sich als eine neue Alternative bei dieser Indikation an. In einer Metaanalyse überwiegend älterer Studien erschienen sie bei Zystitis und Pyelonephritis als gut geeignete Alternativen [5,6]. Ebenso werden siez.…”

Draft Genome Sequence of Corynebacterium coyleae UMB8490, Isolated from the Female Urinary Tract

“…PATRIC's annotation also identified a CRISPR array with 120 spacers. While PATRIC identified several genes associated with antibiotic resistance, analysis by ResFinder v3.2 (11) detected only resistance to aminoglycoside, which is used for single-dose treatment of UTIs (12). Further analysis of this genome will advance our understanding of the role that C. coyleae plays in the female urinary tract.…”