Antimicrobial susceptibility estimation of uncomplicated urinary tract infection pathogens to oral beta-lactam antibiotics with a mathematical model
DOI:
https://doi.org/10.6016/ZdravVestn.2855Keywords:
urinary tract infections, cephalosporins, cefadroxil, antimicrobial susceptibilityAbstract
Background: Uncomplicated urinary tract infections are among the most common infections in young healthy women. When treating such infections we use narrow-spectrum antibiotics with activity against the most common pathogens. The treatment of such infections is usually empirical, therefore in our study we estimated the susceptibility of the most common isolates to oral betalactam antibiotics to determine whether they are an acceptable alternative in case of contraindications to first-line agents.
Methods: We used a theoretical distribution of the frequency of urinary tract pathogens and antimicrobial susceptibilities from clinical urinary cultures in women to calculate an estimate of overall susceptibility of the pathogens using a mathematical model.
Results: The estimated susceptibility to ampicillin was low (50%), but much higher for cephalosporins of 1st to 3rd generation (88% – 90%).
Conclusion: The mathematical model for susceptibility estimation represents an interesting tool for predicting clinical efficacy of antibiotics, based on local antibiotic susceptibility and frequency of pathogens. Our results show that among betalactam antibiotics, 1st generation cephalosporins are suitable for the treatment of uncomplicated cystitis.
Downloads
References
1. Bonkat GC, Pickard RC, Bartoletti R, Bruyère F, Geerlings S, Wagenlehner F, et al. Guidelines on Urological Infections 2017. European Association of Urology. [cited 2017 Sep 7]. Available from: http://uroweb.org/guideline/urological-infections/.
2. Hooton TM, Gupta K. Acute Complicated cystitis and pyelonephritis. In: Bloom A. UpToDate. [cited 2017 Sep 15]. Available from: https://www.uptodate.com/contents/acute-complicated-urinary-tract-infection-including-pyelonephritis-in-adults.
3. Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012;366(11):1028-37.
DOI: 10.1056/NEJMcp1104429
PMID: 22417256
4. Tandogdu Z, Wagenlehner FM. Global epidemiology of urinary tract infections. Curr Opin Infect Dis. 2016;29(1):73-9.
DOI: 10.1097/QCO.0000000000000228
PMID: 26694621
5. Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al.; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-20.
DOI: 10.1093/cid/ciq257
PMID: 21292654
6. Štrumbelj I, Pirš M, Berce I, Fišer J, Golle A, Harlander T, et al. Občutljivost pogostih bakterij za antbiotike v Sloveniji po podatkih SKIJOP, 2017-2016. In: Beović B, Lejko Zupanc T, Tomažič J. Stopenjska diagnostika in zdravljenje pogostih okužb. Ljubljana: Sekcija za protimikrobno zdravljenje SZD; 2017. pp. 43-52.
7. Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE; Infectious Diseases Society of America (IDSA). Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Clin Infect Dis. 1999;29(4):745-58.
DOI: 10.1086/520427
PMID: 10589881
8. The European Committee on Antimicrobial Susceptibility TestingBreakpoint tables for interpretation of MICs and zone diameters. Version 8.0, 2018. EUCAST. [cited 2018 Mar 11]. Available from: http://www.eucast.org/clinical_breakpoints/.
9. Paterson DL. "Collateral damage" from cephalosporin or quinolone antibiotic therapy. Clin Infect Dis. 2004;29(Supplement_4):S341-5.
DOI: 10.1086/382690
PMID: 15127367
10. The European Committee on Antimicrobial Susceptibility TestingEUCAST breakpoints for oral cephalosporins. Guidance Document. [cited 2018 Mar 11]. Available from: .
11. Jorgensen S, Zurayk M, Yeung S, Terry J, Dunn M, Nieberg P, et al. Risk factors for early return visits to the emergency department in patients with urinary tract infection. Am J Emerg Med. 2018;36(1):12-7.
DOI: 10.1016/j.ajem.2017.06.041
PMID: 28655424
12. Vahlensieck W, Perepanova T, Bjerklund Johansen TE, Tenke P, Naber KG, Wagenlehner FM. Management of uncomplicated recurrent urinary tract infections. Eur Urol Suppl. 2016;15(4):95-101.
DOI: 10.1016/j.eursup.2016.04.007
13. Bodmann K, Grabein B, Kresken M, Derendorf H, Stahlmann R, Ott S; Paul-Ehrlich-Gesellschaft für Chemotherapie e.V; et al. Kalkulierte parenterale Initialtherapie bakterieller Erkrankungen bei Erwachsenen – Update. [cited 2019 Apr 1]. Available from: https://www.awmf.org/uploads/tx_szleitlinien/S82-006l_S2k_Parenterale_Antibiotika_2018-1.pdf.
Downloads
Published
Issue
Section
License
The Author transfers to the Publisher (Slovenian Medical Association) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Slovenian Medical Association) has the right to transfer the rights of acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.