OBJECTIVES: This study aims to evaluate the impact of resistance to fluoroquinolones on the short-term outcome of community-acquired urinary tract infections (UTIs) caused by Escherichia coli. METHODS: Patients were identified and followed, during 2006, using the health care databases of the Emilia-Romagna Region. The outcome of interest was the treatment failure/short-term relapse (the re-isolation of E. coli from urine between 4 and 30 days after the first isolation). RESULTS: Resistance to fluoroquinolones increases the risk of treatment failure/short-term relapse in women with uncomplicated community-acquired UTIs caused by E. coli (Rate Ratio=1.85, 95% CI 1.32-2.60). The efficacy of fluoroquinolones for community-acquired UTIs of men was significantly modified by the resistance status of E. coli. Prescription of these agents was associated with a reduced occurrence of the outcome only in men with a ciprofloxacin sensitive first isolate (Rate Ratio=0.50, 95% CI 0.25-0.99). CONCLUSIONS: Resistance to fluoroquinolones of E. coli is a growing problem with a negative impact on the outcome of community-acquired UTIs; therefore, the prescription of these agents should be limited to infections for which they are recommended, avoiding their use in uncomplicated UTIs.
OBJECTIVES: This study aims to evaluate the impact of resistance to fluoroquinolones on the short-term outcome of community-acquired urinary tract infections (UTIs) caused by Escherichia coli. METHODS:Patients were identified and followed, during 2006, using the health care databases of the Emilia-Romagna Region. The outcome of interest was the treatment failure/short-term relapse (the re-isolation of E. coli from urine between 4 and 30 days after the first isolation). RESULTS: Resistance to fluoroquinolones increases the risk of treatment failure/short-term relapse in women with uncomplicated community-acquired UTIs caused by E. coli (Rate Ratio=1.85, 95% CI 1.32-2.60). The efficacy of fluoroquinolones for community-acquired UTIs of men was significantly modified by the resistance status of E. coli. Prescription of these agents was associated with a reduced occurrence of the outcome only in men with a ciprofloxacin sensitive first isolate (Rate Ratio=0.50, 95% CI 0.25-0.99). CONCLUSIONS: Resistance to fluoroquinolones of E. coli is a growing problem with a negative impact on the outcome of community-acquired UTIs; therefore, the prescription of these agents should be limited to infections for which they are recommended, avoiding their use in uncomplicated UTIs.
Authors: Maria Karczmarczyk; Marta Martins; Teresa Quinn; Nola Leonard; Séamus Fanning Journal: Appl Environ Microbiol Date: 2011-08-19 Impact factor: 4.792
Authors: Sofia Maraki; George Samonis; Petros I Rafailidis; Evridiki K Vouloumanou; Emmanuel Mavromanolakis; Matthew E Falagas Journal: Antimicrob Agents Chemother Date: 2009-08-17 Impact factor: 5.191
Authors: M C MacKinnon; J M Sargeant; D L Pearl; R J Reid-Smith; C A Carson; E J Parmley; S A McEwen Journal: Antimicrob Resist Infect Control Date: 2020-12-10 Impact factor: 4.887