Antibiotics for complicated urinary tract infection and acute pyelonephritis: A systematic review

Ong, Leong Tung

doi:10.5495/wjcid.v10.i3.33

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…Because of the relevant negative side effects, the use of fluoroquinolones as first-line antibiotics has been discouraged. Since fluoroquinolones are well absorbed by the gastrointestinal tract and can penetrate the kidney, the Infectious Diseases Society of America and European Society of Clinical Microbiology and Infectious Diseases recommend that the use of oral fluoroquinolones should be limited to the treatment of acute pyelonephritis and complicated UTIs [ 27 ]. Moreover, recently, it has been reported that fluoroquinolones are still in use for lower UTI management [ 28 ].…”

Section: Antibiotics and Upecsmentioning

confidence: 99%

Urinary Tract Infections Caused by Uropathogenic Escherichia coli Strains—New Strategies for an Old Pathogen

Zagaglia

Ammendolia²,

Maurizi

et al. 2022

Microorganisms

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Urinary tract infections (UTIs) are among the most common infections worldwide. Uropathogenic Escherichia coli (UPECs) are the main causative agent of UTIs. UPECs initially colonize the human host adhering to the bladder epithelium. Adhesion is followed by the bacterial invasion of urothelial epithelial cells where they can replicate to form compact aggregates of intracellular bacteria with biofilm-like properties. UPEC strains may persist within epithelial urothelial cells, thus acting as quiescent intracellular bacterial reservoirs (QIRs). It has been proposed that host cell invasion may facilitate both the establishment and persistence of UPECs within the human urinary tract. UPEC strains express a variety of virulence factors including fimbrial and afimbrial adhesins, invasins, iron-acquisition systems, and toxins, which cooperate to the establishment of long lasting infections. An increasing resistance rate relative to the antibiotics recommended by current guidelines for the treatment of UTIs and an increasing number of multidrug resistant UPEC isolates were observed. In order to ameliorate the cure rate and improve the outcomes of patients, appropriate therapy founded on new strategies, as alternative to antibiotics, needs to be explored. Here, we take a snapshot of the current knowledge of coordinated efforts to develop innovative anti-infective strategies to control the diffusion of UPECs.

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Section: Antibiotics and Upecsmentioning

confidence: 99%

Urinary Tract Infections Caused by Uropathogenic Escherichia coli Strains—New Strategies for an Old Pathogen

Zagaglia

Ammendolia²,

Maurizi

et al. 2022

Microorganisms

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“…18 For cUTIs in the outpatient setting, current guidelines (Infectious Diseases Society of America and European Society of Clinical Microbiology and Infectious Diseases) recommend the use of oral fluoroquinolones (such as ciprofloxacin), and oral amoxicillin-clavulanate potassium (AMC), cephalosporin, and trimethoprim-sulfamethoxazole (TMP-SMX) as alternatives. 19 Nitrofurantoin, is restricted to cUTIs that only involve the lower genitourinary tract. 20 Increased resistance to all of these antibiotics has been observed, raising the risk of choosing an empirical antibiotic to which an infecting pathogen is resistant.…”

Section: Introductionmentioning

confidence: 99%

Multiplex Polymerase Chain Reaction/Pooled Antibiotic Susceptibility Testing Was Not Associated with Increased Antibiotic Resistance in Management of Complicated Urinary Tract Infections

Korman¹,

Mathur²,

Luke³

et al. 2023

IDR

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Objective To compare antibiotic resistance results at different time points in patients with urinary tract infections (UTIs), who were either treated based upon a combined multiplex polymerase chain reaction (M-PCR) and pooled antibiotic susceptibility test (P-AST) or were not treated. Methods The M-PCR/P-AST test utilized here detects 30 UTI pathogens or group of pathogens, 32 antibiotic resistance (ABR) genes, and phenotypic susceptibility to 19 antibiotics. We compared the presence or absence of ABR genes and the number of resistant antibiotics, at baseline (Day 0) and 5–28 days (Day 5–28) after clinical management in the antibiotic-treated (n = 52) and untreated groups (n = 12). Results Our results demonstrated that higher percentage of patients had a reduction in ABR gene detection in the treated compared to the untreated group (38.5% reduction vs 0%, p = 0.01). Similarly, significantly more patients had reduced numbers of resistant antibiotics, as measured by the phenotypic P-AST component of the test, in the treated than in the untreated group (42.3% reduction vs 8.3%, p = 0.04). Conclusion Our results with both resistance gene and phenotypic antibiotic susceptibility results demonstrated that treatment based upon rapid and sensitive M-PCR/P-AST resulted in reduction rather than induction of antibiotic resistance in symptomatic patients with suspected complicated UTI (cUTI) in an urology setting, indicating this type of test is valuable in the management of these types of patients. Further studies of the causes of gene reduction, including elimination of ABR gene-carrying bacteria and loss of ABR gene(s), are warranted.

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The Treatment of Urinary Tract Infections Caused by ESBL-Producing Gram-Negative Bacteria, Vancomycin-Resistant Enterococci (VRE), and Other Multidrug-Resistant Bacteria

Stangl,

Kranz,

Wagenlehner

et al. 2024

Guide to Antibiotics in Urology

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Antibiotics for complicated urinary tract infection and acute pyelonephritis: A systematic review

Cited by 5 publications

References 22 publications

Urinary Tract Infections Caused by Uropathogenic Escherichia coli Strains—New Strategies for an Old Pathogen

Urinary Tract Infections Caused by Uropathogenic Escherichia coli Strains—New Strategies for an Old Pathogen

Multiplex Polymerase Chain Reaction/Pooled Antibiotic Susceptibility Testing Was Not Associated with Increased Antibiotic Resistance in Management of Complicated Urinary Tract Infections

The Treatment of Urinary Tract Infections Caused by ESBL-Producing Gram-Negative Bacteria, Vancomycin-Resistant Enterococci (VRE), and Other Multidrug-Resistant Bacteria

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