BERKELEY, CA (UroToday.com) - An increasing trend of multi-drug resistance of E. coli from community-acquired urinary tract infections (CA-UTI) requires other treatment options. In terms of candidate antibiotics for CA-UTI, especially for cystitis which is a very common but not serious infection in community, selective pressure by antibiotics as well as treatment efficiency should be carefully considered. With this perspective, fosfomycin (FM), nitrofurantoin (NI) and temocillin (TMO) would be good candidate antibiotics for uncomplicated cystitis from community.
In this study, we evaluated in vitro susceptibility of E. coli isolates from CA-UTI to FM, NI, TMO as well as trimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). The three antibiotics had an excellent susceptibility profile, mainly because FM is not commonly prescribed, and TMO and NI are not available in Korea: FM 100% (346/346), TMO 96.8% (335/346) and NI 99.4% (344/346). However, resistance rates of CIP and SMX were as high as 22% and 29.2%, and ESBL-positive rate was 8.2% (24/294). Co-resistance rates of CIP and SMX or CIP, SMX and extended-spectrum cephalosporins were 10.6-12.8% or 1.3-3.8% in our previous report. FM and NI did not show a tendency for co-resistance with CIP, SMX or FEP, although ESBL/PABL-positive isolates were a little more resistant to TMO in this study.
We concluded that NI and FM, in addition to TMO, are a good therapeutic option for uncomplicated CA-UTI, especially for lower UTI in Korea.
Written by:
Mi-Ran Seo and Hyunjoo Pai as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Division of Infectious Diseases, Department of Internal Medicine, Hanyang University, Seoul, Korea