Patients with uncomplicated UTI caused by trimethoprim-resistant organisms had significantly worse clinical outcomes than those with trimethoprim-susceptible organisms. Nevertheless, trimethoprim resistance was rarer than predicted from routine laboratory submissions and we calculate that 23 women require microbiological investigation to prevent one reconsultation arising from resistance-based treatment failure. We therefore suggest empirical antibiotic treatment in acute, uncomplicated UTIs. If patients reconsult in the first week, we suggest a change of antibiotic treatment with urine culture and susceptibility testing then done. More generally, laboratory resources should concentrate on resistance surveillance to inform empirical antibiotic choice.

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The amoebicidal and amoebistatic action in vitro of 24 compounds was tested on two strains of Acanthamoeba, A. polyphaga and A. castellanii, isolated from eye infections in this country. For comparison, the Ryan strain of A. castellanii and Naegleria gruberi L-1 were also examined. Nine compounds showed sufficient activity to merit further consideration, ie, acriflavine, proflavine, hydroxystilbamidine isethionate, paromomycin, miconazole, amphoterin, neomycin, polymyxin, and the last two combined in Neosporin.

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