Lactobacilli vs Antibiotics to Prevent Urinary Tract Infections

Beerepoot, M.A.J.

doi:10.1001/archinternmed.2012.777

Cited by 190 publications

(86 citation statements)

References 21 publications

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“…One limitation of our study is that although it tested resistance to a wide range of antibiotics, not all antibiotic recommendations in the guidelines were covered on a one-on-one basis and in some cases we had to use the prevalence of resistance to a similar antibiotic [30,31]. Also, since we excluded patients with current infections or risk factors for AMR (antibiotic use or hospitalisation in the past 3 months), the level of AMR might be an underestimation for the total population in the community.…”

Section: Discussionmentioning

confidence: 99%

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Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureusin the community

et al. 2014

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BackgroundOver 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons.MethodsThe prevalence of antimicrobial resistance in S. aureus was analysed by taking nose swabs from healthy primary care patients in nine European countries (total N = 32,032). Primary care treatment guidelines for bacterial skin infections were interpreted with respect to these antimicrobial resistance patterns. First- and second-choice recommendations were assessed and considered congruent if resistance to the antibiotic did not exceed 20%.ResultsWe included primary care treatment guidelines for impetigo, cellulitis, folliculitis and furuncle. Treatment recommendations in all countries were consistent: most of the first-choice recommendations were beta-lactams, both for children and adults. Antimicrobial resistance levels were low, except for penicillin (on average 73% resistance). Considerable variation in antimicrobial resistance levels was found between countries, with Sweden displaying the lowest levels and Spain the highest. In some countries resistance to penicillin and azithromycin was significantly higher in children (4-17 years) compared with adults.ConclusionsMost of the first- and second-choice recommendations in the treatment guidelines for skin infections were congruent with commensal S. aureus antimicrobial resistance patterns in the community, except for two recommendations for penicillin. Given the variation in antimicrobial resistance levels between countries, age groups and health care settings, national data regarding antimicrobial resistance in the community should be taken into account when updating or developing primary care treatment guidelines.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-014-0175-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…since no clarithromycin resistance was tested we used data of azithromycin resistance (see Additional file 2: Table S2). Recent studies have shown that resistance to similar antibiotics can serve as a reliable indicator for the level of resistance to the original antibiotic [30,31]. …”

Section: Methodsmentioning

confidence: 99%

Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureusin the community

et al. 2014

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“…In randomised trials comparing continuous co-trimoxazole (480mg daily) with cranberry extract12 and lactobacillus,13 resistance to co-trimoxazole, trimethoprim and amoxicillin in faeces and urine (measured by testing antibacterial sensitivity in the laboratory) had increased after 1 month of antibacterial use (from around 21–28% to around 73–91% in one trial;12 and from around 20–40% to around 80–95% in the other) 13. After 12 months' prophylactic therapy, resistance rates for ciprofloxacin and norfloxacin in urinary Escherichia coli isolates had also increased.…”

Section: Preventing Recurrent Infectionsmentioning

confidence: 99%

“…A more recent double-blind, double-dummy randomised controlled trial in 252 postmenopausal women with recurrent UTIs compared 12 months' prophylaxis with either co-trimoxazole (480mg daily) or oral capsules containing Lactobacillus ( twice daily) 13. The trial included women with complicated UTIs.…”

Section: Preventing Recurrent Infectionsmentioning

confidence: 99%

Prevention of recurrent urinary tract infections in women

2013

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Around 40-50% of women experience at least one urinary tract infection (UTI) during their lifetime and 20-30% of these have a recurrence within 3-4 months of the initial infection.¹ Recurrent UTI (usually defined as three episodes in the last 12 months or two episodes in the last 6 months) can have a considerable impact on a woman's quality of life. Each episode of acute UTI in young women is typically associated with about 6 days of symptoms, 2.4 days of restricted activities and 0.4 days of bed rest.¹ Antibacterial prophylaxis is effective in preventing recurrent episodes, but at the expense of unwanted effects and a risk of promoting bacterial resistance. Here we assess the efficacy of different antibacterial regimens and non-antibacterial alternatives (cranberry, probiotics, oestrogens, immunostimulation, hyaluronic acid and chondroitin, acupuncture and herbs) in the prevention of recurrent uncomplicated UTIs in women.

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“…Quinolone therapy during the prior 6 months increased the odds that a febrile UTI was caused by a quinolone-resistant organism 17.5 times in outpatients 7. Trimethoprim/sulfamethoxazole prophylaxis for 1 month in postmenopausal women increased resistant Escherichia coli in the stool from approximately 20% to 85% 8. Of interest, a recent study found that antibiotic treatment of asymptomatic bacteriuria in young women increased the risk of subsequent symptomatic UTI 3 times.…”

mentioning

confidence: 99%