Clinical Management of an Increasing Threat: Outpatient Urinary Tract Infections Due to Multidrug-Resistant Uropathogens

Emily Walker, Alessandra Lyman, Kalpana Gupta, Monica V. Mahoney, Graham M. Snyder, Elizabeth B. Hirsch

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Urinary tract infections (UTIs) are among the most commonly treated bacterial infections. Over the past decade, antimicrobial resistance has become an increasingly common factor in the management of outpatient UTIs. As treatment options for multidrug-resistant (MDR) uropathogens are limited, clinicians need to be aware of specific clinical and epidemiological risk factors for these infections. Based on available literature, the activity of fosfomycin and nitrofurantoin remain high for most cases of MDR Escherichia coli UTIs. Trimethoprim-sulfamethoxazole retains clinical efficacy, but resistance rates are increasing internationally. Beta-lactam agents have the highest rates of resistance and lowest rates of clinical success. Fluoroquinolones have high resistance rates among MDR uropathogens and are being strongly discouraged as first-line agents for UTIs. In addition to accounting for local resistance rates, consideration of patient risk factors for resistance and pharmacological principles will help guide optimal empiric treatment of outpatient UTIs.

Original languageEnglish (US)
Pages (from-to)960-965
Number of pages6
JournalClinical Infectious Diseases
Volume63
Issue number7
DOIs
StatePublished - Oct 1 2016

Keywords

  • cystitis
  • resistance
  • urinary tract infection
  • uropathogens

Fingerprint Dive into the research topics of 'Clinical Management of an Increasing Threat: Outpatient Urinary Tract Infections Due to Multidrug-Resistant Uropathogens'. Together they form a unique fingerprint.

Cite this