Uncomplicated Urinary Tract Infections

Wagenlehner, Florian M. E.; Hoyme, U. B.; Kaase, Martin; Fünfstück, R; Naber, Kurt G.; Schmiemann, Guido

doi:10.3238/arztebl.2011.0415

Cited by 76 publications

(70 citation statements)

References 25 publications

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“…Integrons are transferable genetic elements capable of expressing multiple resistance genes in cassette structures and are strongly associated with multidrug resistance (33). Concerns over increased resistance and the collateral effects of TMP/SMX use has led to the removal of TMP/SMX as a recommended agent from some guidelines (35). However, a recent systematic review did not find an increase in bacterial resistance to other antimicrobial classes with the use of TMP/SMX as prophylaxis in patients with HIV (29).…”

Section: Discussionmentioning

confidence: 98%

Has the Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Increased Trimethoprim-Sulfamethoxazole Use and Resistance?: a 10-Year Time Series Analysis

Wood¹,

Smith²,

Baker

et al. 2012

Antimicrob Agents Chemother

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There are an increasing number of indications for trimethoprim-sulfamethoxazole use, including skin and soft tissue infections due to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Assessing the relationship between rates of use and antibiotic resistance is important for maintaining the expected efficacy of this drug for guideline-recommended conditions. Using interrupted time series analysis, we aimed to determine whether the 2005 emergence of CA-MRSA and recommendations of trimethoprim-sulfamethoxazole as the preferred therapy were associated with changes in trimethoprim-sulfamethoxazole use and susceptibility rates. The data from all VA Boston Health Care System facilities, including 118,863 inpatient admissions, 6,272,661 outpatient clinic visits, and 10,138 isolates were collected over a 10-year period. There was a significant (P ‫؍‬ 0.02) increase in trimethoprim-sulfamethoxazole prescriptions in the post-CA-MRSA period (1,605/year) compared to the pre-CA-MRSA period (1,538/year). Although the overall susceptibility of Escherichia coli and Proteus spp. to trimethoprim-sulfamethoxazole decreased over the study period, the rate of change in the pre-versus the post-CA-MRSA period was not significantly different. The changes in susceptibility rates of S. aureus to trimethoprim-sulfamethoxazole and to methicillin were also not significantly different. The CA-MRSA period is associated with a significant increase in use of trimethoprim-sulfamethoxazole but not with significant changes in the rates of susceptibilities among clinical isolates. There is also no evidence for selection of organisms with increased resistance to other antimicrobials in relation to increased trimethoprim-sulfamethoxazole use.

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Section: Discussionmentioning

confidence: 98%

Has the Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Increased Trimethoprim-Sulfamethoxazole Use and Resistance?: a 10-Year Time Series Analysis

Wood¹,

Smith²,

Baker

et al. 2012

Antimicrob Agents Chemother

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“…These agents account for 8-10% of antibiotic prescriptions in Germany; in the last decade, rates of resistance to them have risen as well (3,4). In 2010, the S3 guideline of the Association of Scientific Medical Societies in Germany (AWMF) for uncomplicated UTI no longer recommended cotrimoxazole as a drug of first choice for this indication, because of increasing resistance (5). Rather, the new recommendation is for fosfomycin-trometamol and nitrofurantoin as drugs of first choice for this indication in Germany (and also pivmecillinam outside Germany), with fluoroquinolones as second-line agents.…”

mentioning

confidence: 99%

A Survey of Outpatient Antibiotic Prescribing for Cystitis

Velasco

Noll²,

Espelage³

et al. 2012

Deutsches Ärzteblatt International

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“…Recent studies with patients with uncomplicated cystitis, however, showed a general increase in TMP and fluoroquinolone resistance (3,9). Current guidelines for the treatment of uncomplicated UTI no longer recommend TMP or TMP-SMX as first-line agents if the regional resistance rate against TMP is higher than 20% (10)(11)(12). In the past, fluoroquinolones have also been recommended as first-line treatment for uncomplicated cystitis (4).…”

mentioning

confidence: 99%

Urinary Concentrations and Antibacterial Activities of Nitroxoline at 250 Milligrams versus Trimethoprim at 200 Milligrams against Uropathogens in Healthy Volunteers

Wagenlehner

Münch

Pilatz

et al. 2014

Antimicrob Agents Chemother

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Uncomplicated Urinary Tract Infections

Abstract: The new S3 guideline on uncomplicated UTI incorporates a forward-looking approach to the use of antibiotics in treating this common type of infection. It is intended to bring about a sustained improvement in the quality of care.

Cited by 76 publications

References 25 publications

Has the Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Increased Trimethoprim-Sulfamethoxazole Use and Resistance?: a 10-Year Time Series Analysis

Has the Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Increased Trimethoprim-Sulfamethoxazole Use and Resistance?: a 10-Year Time Series Analysis

A Survey of Outpatient Antibiotic Prescribing for Cystitis

Urinary Concentrations and Antibacterial Activities of Nitroxoline at 250 Milligrams versus Trimethoprim at 200 Milligrams against Uropathogens in Healthy Volunteers

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