Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections

Kang, Cheol-In; Kim, Jieun; Park, Dae Won; Kim, Baek-Nam; Ha, U-Syn; Lee, Seung‐Ju; Yeo, Jeong Kyun; Min, Seung Ki; Lee, Heeyoung; Wie, Seong Heon

doi:10.3947/ic.2018.50.1.67

Cited by 184 publications

(144 citation statements)

References 143 publications

(206 reference statements)

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“…La resistencia de Escherichia coli a la ciprofloxacina presenta una tasa superior al 25% en los años de estudiados. Recordamos que este germen presenta una resistencia a la ciprofloxacina de (32,35) alrededor del 30% en otras publicaciones . Las quinolonas son un grupo de antimicrobianos que ha presentado un aumento progresivo de consumo ambulatorio a través de los años.…”

Section: Escherichia Coli Y Resistencia a Antibióticos De Segunda Líneaunclassified

Use of second-line antibiotics for the treatment of uncomplicated acute cystitis in women: current approach

Segovia

Bogado

Ovando

et al. 2018

Rev. virtual Soc. Parag. Med. Int

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RESUMENFundamento y objetivo: con este estudio pretendemos identificar los antibióticos considerados de segunda línea para el uso en las infecciones de vías urinarias (IVU), específicamente en las cistitis no complicadas de la mujer. Posteriormente nos proponemos presentar la prevalencia de resistencia a los antibióticos de segunda línea de los gérmenes más frecuentemente encontrados en las IVU en el Laboratorio de Microbiología de la Facultad de Ciencias Médicas, de la Universidad Nacional de Asunción. Material y método: se realizó un trabajo observacional, descriptivo, de corte transverso. Resultados: Escherichia coli presenta un resistencia inferior al 20% en promedio para la cefuroxima, que se mantiene en el lapso observado (2010 -2017). La resistencia a la ampicilina-sulbactam de dicho germen está variando, de una resistencia elevada en los primeros años de la observación, hasta un acercamiento progresivo en los años precedentes al 30% (en promedio 34%). La resistencia a la ciprofloxacina presenta una tasa superior al 25% en los años de estudiados. En cuanto a la resistencia de Klebsiella pneumoniae a los antibióticos de segunda línea, en los últimos dos años de observación, tanto al grupo de las cefalosporinas, de la ampicilina sulbactam y la ciprofloxacina, se encontró una resistencia mayor al 30%. Conclusiones: los datos muestran una importante resistencia de Escherichia coli y Klebsiella pneumoniae aislados en los urocultivos a los antibióticos identificados como de segunda línea para el tratamiento de las cistitis no complicadas de la mujer, por lo que debe otorgársele un gran peso a los resultados de los urocultivos para la utilización apropiada de estos antibióticos. ABSTRACT Background and objective:With this study we intended to identify the second-line antibiotics to be used in urinary tract infections (UTI), specifically in uncomplicated cystitis of women. Later, we proposed to present the prevalence of resistance to the second-line antibiotics of the germs most frequently found in the UTI in the Microbiology Material and method: An observational, descriptive, cross-sectional study was carried out. Results: Escherichia coli has a resistance to cefuroxine lower than 20% on average, which was maintained in the observed period (2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017). The resistance to ampicillin-sulbactam of this germ is varying, from a high resistance in the first years of the observation to a progressive approach to 30% in the preceding years (on average 34%). Resistance to ciprofloxacin presents a rate higher than 25% in the studied years. Regarding the resistance of Klebsiella pneumoniae to the second-line antibiotics, a resistance greater than 30% was found for the group of cephalosporins, ampicillin sulbactam and ciprofloxacin in the last two years of observation. Conclusions:The data show an important resistance of Escherichia coli and Klebsiella pneumoniae isolated in urine cultures to the second-line antibiotics for the treatment of uncomplicated cystitis in women. Therefore, a grea...

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Section: Escherichia Coli Y Resistencia a Antibióticos De Segunda Líneaunclassified

Use of second-line antibiotics for the treatment of uncomplicated acute cystitis in women: current approach

Segovia

Bogado

Ovando

et al. 2018

Rev. virtual Soc. Parag. Med. Int

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“…Empirical antibiotics such as fosfomycin, fluoroquinolones, β lactams, Nitrofurantoin, and pivmecillinam used to be the mainstay of management for UTI cases (9). However, this random approach increased the recurrence rates and resulted in the emergence of resistant, multi-resistant, and even pan-resistant strains.…”

Section: Introductionmentioning

confidence: 99%

Ciprofloxacin Resistance in Hospital and Community-acquired Urinary Tract Infections by Escherichia coli: A Systematic Review and Meta-analysis

Zhou

2020

Preprint

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In recent years, antimicrobial resistance has been increasingly reported. One main concern is the resistance of gram-negative bacteria like E. coli to ciprofloxacin (fluoroquinolones).Gram-negative bacteria are the main cause of community and hospital-acquired urinary tract infections (UTI). We aimed to review and analyze the data on ciprofloxacin resistance in hospital and community-acquired UTI. A literature search of three electronic databases (PubMed, Medline, and Cochrane) was performed. We considered the papers that were published from January 2004 to May 2019. The search yielded a total of 16097 studies besides 31 studies from a manual search. Filtering yielded 1297 relevant full-text papers.Eighty-three papers, equivalent of 99 cohorts, were finally included in this systematic review and in the analysis. The analysis results suggest that pooled ciprofloxacin resistance for community and hospital-acquired E. coli UTI is 0.27 (95% CI 0.246-0.303) and 0.30 (95% CI 0.22-0.38), respectively. Pooled resistance rates according to regions are 0.43 (95% CI 0.31-0.54) for Asia ensued by Africa 0.31 (95% CI 0.22-0.35), the Middle East 0.21(95% CI 0.13-0.30), Europe 0.18 (95% CI 0.13-0.22), and Australia 0.06 (95% CI 0.04-0.08). The pooled estimates revealed that ciprofloxacin resistance was higher in developing countries compared to that in developed countries, 0.35 (95% CI 0.30-0.40) and 0.13 (95% CI 0.10-0.16), respectively. Finally, plotting resistance over time deemed statistically significant (n= 79, r= 0.29, p= 0.038). Our findings suggest that ciprofloxacin resistance among UTI patients is a highly prevalent and serious issue. The suggested risks are low-income, acquiring hospital infection, and falling in highly-vulnerable regions like Asia and Africa. We also shed light on some approaches to correct the perception of patients and general practitioners (GPs) for antibiotic usage. We also suggest ideas to impede the progress of the post-antibiotic era in countries known for high antibiotic resistance.Blocking this enzyme accumulates the supercoiled DNA and impedes organism replication as a result (12). Ciprofloxacin has been the most effective empirical treatment for UTI, but patients are becoming more resistant to it. For example, the resistance raised from 24.9% in 2010 to 40.7% in 2015 among Brazilian patients treated for E.coli UTI (13). Herein, we review and update rates of ciprofloxacin resistance and compare resistance in CA-UTI with that in HA-UTI caused by gram-negative E. coli.Papers with data on prevalence or incidence of ciprofloxacin resistance in CA or HA E.coli UTI were included. The main inclusion criteria were: (1) English articles published between 2004 and 2019 in peer-reviewed journals, (2) studies conducted on either adults or children.Nonrelevant papers with the following characteristics were excluded: (1) grey literature, (2) comments, (3) letters to editors, (4) conference abstracts, (5) reports, (6) theses, (7) non-peer reviewed studies, (8) review articles, and (9) articles with samp...

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“…Urinary tract infections (UTIs) are one of the most common bacterial infections. Approximately 40-50% of women experience UTIs at least once in their lifetime [1][2][3]. Acute pyelonephritis (APN) is a type of UTI that manifests as pain during urination, fever, chills, ank pain, nausea, and vomiting.…”

Section: Introductionmentioning

confidence: 99%

“…In APN resulting from urinary tract obstruction, the types of causative bacteria and their antibiotic susceptibility vary depending on the disease severity, geographical region, cause of urinary tract obstruction, and patient history of healthcare-associated infections (HCAIs) or community-acquired infections, and evidence is currently insu cient to make other antibiotic recommendations for such patients [1].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Antimicrobial Resistance in Patients with Obstructive Pyelonephritis Associated with Ureteral Stones and Uncomplicated Pyelonephritis

Ahn

Won

et al. 2020

Preprint

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Background This study aimed to investigate the clinical outcomes and antibiotic susceptibilities of causative microorganisms in patients with obstructive pyelonephritis associated with ureteral stones (OPU). Methods This retrospective cohort study included female patients diagnosed with community-acquired acute pyelonephritis (APN) at a tertiary care hospital from 2008 to 2017. Cases of APN associated with obstruction of the upper urinary tract due to the presence of ureteral stones and cases of APN without complications were compared. Propensity score matching was used to adjust for heterogeneity within each group. Results Of the 588 female patients with community-acquired APN, 107 patients were diagnosed with OPU and 481 patients were diagnosed with uncomplicated APN. Propensity score matching revealed that Enterobacteriaceae strains isolated from OPU cases were more resistant to fluoroquinolones (51.9% vs. 16.0%, p < 0.001). Extended-spectrum β-lactamase was detected in 22.2% and 21.0% of the Enterobacteriaceae strains isolated from OPU cases and uncomplicated APN cases, respectively (p = 1.000). The treatment failure rate was similar in the OPU and uncomplicated APN groups (16.0% vs. 21.0%, p = 0.545). Conclusions Antibiotic treatment for patients with OPU may be empirically selected in accordance with the treatment protocol for general pyelonephritis. Clinicians should exercise caution before prescribing fluoroquinolones for the treatment of OPU.

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Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections

Cited by 184 publications

References 143 publications

Use of second-line antibiotics for the treatment of uncomplicated acute cystitis in women: current approach

Use of second-line antibiotics for the treatment of uncomplicated acute cystitis in women: current approach

Ciprofloxacin Resistance in Hospital and Community-acquired Urinary Tract Infections by Escherichia coli: A Systematic Review and Meta-analysis

Comparison of Antimicrobial Resistance in Patients with Obstructive Pyelonephritis Associated with Ureteral Stones and Uncomplicated Pyelonephritis

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