Clinical evaluation of guidelines and therapeutic approaches in multi drug-resistant urinary tract infections

Concia, Ercole; Bragantini, Damiano; Mazzaferri, Fulvia

doi:10.1080/1120009x.2017.1380397

Cited by 32 publications

(35 citation statements)

References 30 publications

(29 reference statements)

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“…A recent study recommended the use of amoxicillin/clavulanate (or amoxicillin plus aminoglycoside), cefixime, ceftibuten, levofloxacin, ciprofloxacin, and fosfomycin as empirical antibiotics against catheter-associated UTIs, whereas recommended regimens for empiric treatment of uncomplicated UTIs were fosfomycin, nitrofurantoin and pivmecillinam [ 119 ]. However, cultivation should be performed prior to the use of empirical antibiotics, especially in complicated UTIs because atypical and/or MDR microorganisms are more likely to be isolated.…”

Section: Complicated Utis and Mdr Gram-negative Bacteriamentioning

confidence: 99%

Community-Acquired Urinary Tract Infection byEscherichia coliin the Era of Antibiotic Resistance

Lee

Choe

2018

BioMed Research International

173

106

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Urinary tract infections (UTIs) caused by Escherichia coli (E. coli) are the most common types of infections in women. The antibiotic resistance of E. coli is increasing rapidly, causing physicians to hesitate when selecting oral antibiotics. In this review, our objective is to ensure that clinicians understand the current seriousness of antibiotic-resistant E. coli, the mechanisms by which resistance is selected for, and methods that can be used to prevent antibiotic resistance.

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Section: Complicated Utis and Mdr Gram-negative Bacteriamentioning

confidence: 99%

Community-Acquired Urinary Tract Infection byEscherichia coliin the Era of Antibiotic Resistance

Lee

Choe

2018

BioMed Research International

173

106

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“…Nitrofurantoin is used for acute cystitis, and short-term use is generally well tolerated; susceptibility of ESBL-producing E. coli organisms to this agent is varied [51,57]. Prolonged use is associated with polyneuropathy and interstitial fibrosis.…”

Section: Mild or Uncomplicated Mdr Utimentioning

confidence: 99%

Multidrug-resistant organisms in urinary tract infections in children

et al. 2019

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The global spread of multidrug-resistant organisms has led to an increase in urinary tract infections (UTIs) in children that are difficult to treat. This review explores the current literature regarding multidrug-resistant UTIs in childhood and proposes an approach to management. Multidrug-resistant organisms include a wide range of potential urinary tract pathogens and, while most literature on drug resistance in UTIs during childhood has focused on extended-spectrum beta-lactamase producing organisms, in this review, we have included a discussion of multidrug resistance including and beyond beta-lactamase production. We provide definitions for multidrug-resistant organisms in line with current consensus guidelines and summarise clinically relevant mechanisms of resistance. Additionally, in this review, we outline the global epidemiology of multidrug-resistant UTIs in children, summarising published prevalence rates, which range from 5 to 90% in different settings. Finally, we also critically review the evidence on risk factors for colonisation and infection of the urinary tract with multidrug-resistant organisms, including prior antibiotic use, hospitalisation and underlying urological malformations. We also highlight multidrug-resistant UTI occurring in children without any identifiable risk factors, reflecting an increasing prevalence of colonisation with these organisms in the general community. Taken as a whole, this emphasises a need for careful and evidence-based use of antibiotics when treating UTIs in children and, to aide clinicians, we have outlined here potential management strategies for when infection with a multidrug-resistant organism is suspected or confirmed.

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“…13 According to published data of various European countries, the identified frequency of ESBLs range from 70-100% , meaning that carbapenems often represent the only active available antibiotics. 16 Amongst all the positive cultures, the highest sensitivity was observed for carbapenems, followed by Polymyxin B, phosphonic acid derivatives, aminoglycoside group, extended spectrum penicillins, imidazolidinedione and tetracycline groups. This finding is similar to another study in which treatment options for UTIs with or without ESBLs-producing Enterobacteriaceae include nitrofurantion, fosfomycin, fluoroquinolones, cefoxitin, piperacillin-tazobactam, carbapenems, ceftolozanetazobactam, ceftazidime-avibactam, and aminoglycosides.…”

Section: Discussionmentioning

confidence: 96%

Antimicrobial Sensitivity Pattern for Urine Isolates in Urinary Tract Infection

Bukhari¹,

Bukhari²,

Zafar³

et al. 2019

JIMDC

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Background:The increased frequency and management of antibiotic resistance pattern in urinary tract infection (UTI) is a challenging task for the clinicians. Therefore, the current study was planned to identify the microbial etiology of UTI and t he most suitable antibiotics used. The objective of the study was to assess the frequency of antimicrobial sensitivity pattern in patients with urinary tract infection. Material and Methods: This cross-sectional study was carried out at Al Sayed Hospital, Kidney Centre, Rawalpindi over a period of seven months i.e. June 30, 2018 to January 30, 2019. A total of 152 patients were enrolled according to the inclusion and exclusion criteria of the study. Urine culture proceedings were done as per latest recommended guidelines of Clinical and Laboratory Standard Institute (CLSI) for UTI. Results: Highest sensitivity was observed for carbapenems (83.5%), followed by polymyxin B (72.3%), phosphonic acid derivatives (65.8%), aminoglycoside group (65.7%), extended spectrum penicillin (63.1%), imidazolidinedione (59.9%) and tetracycline (59.9%) groups. The least sensitivity was observed for Oxazolidinone (linezolid) (14.5%), teicoplanin (13.8%), tigecycline (10.5%) and firstgeneration cephalosporins (1.3%). Conclusions: Carbapenems showed maximum sensitivity for all urine isolates. The second and third options were polymyxin B and phosphonic acid derivatives, respectively.

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Clinical evaluation of guidelines and therapeutic approaches in multi drug-resistant urinary tract infections

Cited by 32 publications

References 30 publications

Community-Acquired Urinary Tract Infection byEscherichia coliin the Era of Antibiotic Resistance

Community-Acquired Urinary Tract Infection byEscherichia coliin the Era of Antibiotic Resistance

Multidrug-resistant organisms in urinary tract infections in children

Antimicrobial Sensitivity Pattern for Urine Isolates in Urinary Tract Infection

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