Amoxicillin-Clavulanate vs Ciprofloxacin for the Treatment of Uncomplicated Cystitis in Women

Hooton, Thomas M.; Scholes, Delia; Gupta, Kalpana; Stapleton, Ann E.; Roberts, Pacita L.; Stamm, Walter E.

doi:10.1001/jama.293.8.949

Cited by 162 publications

(107 citation statements)

References 24 publications

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“…Although symptomatic UTIs confirmed by microbiological analysis were the main outcome parameter in this study, all other symptoms were also recorded and considered. All bacterial isolates were identified by standard microbiological methods according to Hooton et al [19], and susceptibility testing was performed according to CLSI (Clinical and Laboratory Standards Institute) recommendations. All MIC values of isolates were interpreted according to the breakpoints of European Committee on Antimicrobial Susceptibility Testing (EUCAST) [20].…”

Section: Data Collection and Microbiological Considerationsmentioning

confidence: 99%

Antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: fosfomycin trometamol, an attractive alternative

Cai

Gallelli²,

Cocci

et al. 2016

World J Urol

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infections (UTIs) occurring within 1 month after TR-PB. The rate of symptomatic UTIs and the rate of ADRs were considered the main outcome measures. Results In the total study population, 72/1109 (6.5 %) patients experienced symptomatic UTIs and among these 11 (0.9 % of total) had urosepsis. Out of 72, 53 (73.6 %) symptomatic UTIs were caused by fluoroquinolone-resistant strains. Out of 632, 10 (1.6 %) patients in Group 1 and 62/477 (12.9 %) patients in Group 2 had symptomatic UTIs (p < 0.001); in particular, 2/632 (0.3 %) patients in Group 1 and 9/477 (1.8 %) patients in Group 2 had urosepsis (p < 0.001). No differences were reported in terms of adverse events (0.6 vs 0.4 %; p = 0.70). A Charlson comorbidity index ≤1 and type of antimicrobial prophylaxis (FT) were found to be associated with a lower probability of symptomatic UTIs in the multivariate model. Conclusions Antibiotic prophylaxis with FT for TR-PB had a lower rate of adverse events and a lower rate of symptomatic UTIs as compared with CIP. Fosfomycin trometamol appears as an attractive alternative prophylactic regimen in prostate biopsies.

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Section: Data Collection and Microbiological Considerationsmentioning

confidence: 99%

Antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: fosfomycin trometamol, an attractive alternative

Cai

Gallelli²,

Cocci

et al. 2016

World J Urol

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“…Most of the relevant studies carried out to date refer to hospitalized patients, and the susceptibility of E. coli varies considerably in different parts of the world [5][6][7][8][9]. Trimethoprim/sulfamethoxazole (TMP/SMX) is the empiric treatment of choice for UTIs, if the local resistance rate is less than 10-20% [10].…”

Section: Introductionmentioning

confidence: 99%

Secular Trend and Risk Factors for Antimicrobial Resistance in Escherichia coli Isolates in Switzerland 1997–2007

et al. 2009

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Background: Antibacterial resistance in Escherichia coli isolates of urinary infections, mainly to fluoroquinolones, is emerging. The aim of our study was to identify the secular trend of resistant E. coli isolates and to characterize the population at risk for colonization or infections with these organisms. Patients and Methods: Retrospective analysis of 3,430 E.coli first isolates of urine specimens from patients admitted to the University Hospital Basel in 1997Basel in , 2000Basel in , 2003Basel in , and 2007. Results: Resistance to ciprofloxacin, trimethoprim/sulfamethoxazole, and amoxicillin/clavulanate has increased over the 10-year study period (from 1.8% to 15.9%, 17.4% to 21.3%, and 9.5% to 14.5%, respectively). A detailed analysis of the 2007 data revealed that independent risk factors for ciprofloxacin resistance were age (5.3% < 35 years of age to 21.9% in patients > 75 years; odds ratio [OR] 1.29 per 10 years, 95% confidence interval [CI] 1.15-1.45, p < 0.001) and male gender (OR 1.59, 95% CI 1.05-2.41, p = 0.04). In contrast, nosocomial E. coli isolates were associated with lower odds of ciprofloxacin resistance (OR 0.51, 95% CI 0.28-0.67, p < 0.001). The frequency of resistant isolate rates was not influenced by the clinical significance (i.e., colonization vs urinary tract infection, UTI) or by whether the urine was taken from a urinary catheter. Importantly, the increase in ciprofloxacin resistance paralleled the increase in ciprofloxacin consumption in Switzerland (Pearson's correlation test R 2 = 0.998, p = 0.002). Of note, resistance was less frequent in isolates sent in by general practitioners. However, after adjustment for age and gender, only resistance against amoxicillin/clavulanate was found to be less frequent (OR 0.34, p = 0.03). Conclusion: Our study reveals that resistance rates have been increasing during the last decade. Published resistance rates may lack information due to important differences regarding age, gender, and probable origin of the isolates. Empirical therapy for UTI should be guided more on individual risk profile and local resistance data than on resistance data banks.

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“…[12,13] Bizim çalışma-mızda ise klinik kür %93, mikrobiyolojik kür %65.8'dir. Çalış-mamızda FT ile karşılaştırdığımız CP ile elde ettiğimiz klinik kür oranları literatürde bildirilen oranlar ile uyumludur.…”

Section: Discussionunclassified

Comparison of Fosfomysin Trometamol and Ciprofloxacin in Uncomplicated Urinary Tract Infections

et al. 2011

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SUMMARY Objectives Acute urinary tract infection (UTI) is one of the most common infections requiring empirical antibiotic therapy. Selection of efficient and safe antimicrobial agent is important in the emergency department (ED). The aim of this study is to compare the microbiological and clinical efficiency of single-dose fosfomycin trometamol (FT) therapy with a 3-day course of ciprofloxacin (CP) for the treatment of uncomplicated UTI. Methods ÖZET AmaçAkut komplike olmayan alt üriner sistem enfeksiyonları en sık ampirik antibiyotik reçete edilen enfeksiyonlardır. Acil serviste (AS) gü-venilir ve etkin bir antimikrobiyal ajan seçimi önemlidir. Bu çalış-manın amacı, acil servise başvuran akut komplike olmayan üriner sistem enfeksiyonu olan hastalarda tek doz fosfomisin trometorol (FT) ve 3 gün siprofloksasinin (CP) klinik ve mikribiyolojik etkinliği-nin karşılaştırılmasıdır. Gereç ve YöntemBu randomize, tek kör, prospektif çalışmada AS'ye semptomları son 72 saat içinde başlayan, dizüri, idrara sıkışma hissi ve sık idrara gitme şikayeti ile başvuran 18-65 yaş kadın hastalar değerlen-dirildi. Bir grup hasta tek doz FT, diğer grup 3 günlük CP tedavisi aldı. İlk idrar kültürlerinde üreme olan hastalar çalışma grubunu oluşturdu. Tedaviden sonraki 7.-10. günlerde klinik ve mikrobiyolojik kür değerlendirildi. Tedavi rejimlerinin etkinliği ki-kare testi ile karşılaştırıldı. BulgularÇalışmadaki 81 kadının yaş ortalaması 30±2 idi. FT grubunda 40, CP grubunda 41 hasta vardı. En sık izole edilen üropatojen 50 ör-nekte bulunan E. coli idi (%61.3). Klinik olarak iyileşme CP grubunda 38 (%93), FT grubunda 38 (%96) hastada saptandı (χ²: 0,347, df: 1, p=0.275). Bakteriyolojik eradikasyon CP grubundaki hastaların 27 (%65,8), FT grubundaki hastaların 32'sinde (%80) elde edildi (χ²: 0.1591, df: 1, p=0.207). FT grubunda yalnızca 3 hastada (%7.5) pirozis görülürken CP grubunda 4 hastada (%10) pirozis, 5 hastada (%12) bulantı görüldü. SonuçKomplike olmayan üriner sistem enfeksiyonu olan kadın hastalarda tek doz FT ampirik antibiyotik olarak CP kadar etkin ve güvenlidir.Anahtar sözcükler: Ampirik tedavi; fosfomisin trometamol; idrar yolu infeksiyonu; siprofloksasin. 104

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Amoxicillin-Clavulanate vs Ciprofloxacin for the Treatment of Uncomplicated Cystitis in Women

Cited by 162 publications

References 24 publications

Antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: fosfomycin trometamol, an attractive alternative

Antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: fosfomycin trometamol, an attractive alternative

Secular Trend and Risk Factors for Antimicrobial Resistance in Escherichia coli Isolates in Switzerland 1997–2007

Comparison of Fosfomysin Trometamol and Ciprofloxacin in Uncomplicated Urinary Tract Infections

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